Provider Demographics
NPI:1063077659
Name:ROBIN BRANNAN LCMFT LLC
Entity type:Organization
Organization Name:ROBIN BRANNAN LCMFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANNAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:240-242-5185
Mailing Address - Street 1:11307 FARMLAND DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4523
Mailing Address - Country:US
Mailing Address - Phone:301-785-8875
Mailing Address - Fax:
Practice Address - Street 1:3720 FARRAGUT AVE STE 301
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2110
Practice Address - Country:US
Practice Address - Phone:240-242-5185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty