Organization
BRANDT THERAPY CLINICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA LAURENE BRANDT PH.D., M.S. (PRESIDENT)
(630) 456-4411
Entity
Organization
Contact information
Practice address
125 E LAKE ST, SUITE 106, BLOOMINGDALE, IL 60108-1179
(630) 307-3782
Mailing address
889 ASBURY LN, SCHAUMBURG, IL 60193-4101
(630) 290-3384
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180.006083
IL
1041C0700X
Clinical Social Worker
—
IL
106H00000X
Marriage & Family Therapist
Primary
166000532
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001635417
BLUE CROSS BLUE SHIELD
IL
01
—
34398000
MAGELLAN
IL
Enumeration date
10/05/2006
Last updated
10/14/2008
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