Provider Demographics
NPI:1619734498
Name:BRENDZE, ARTHUR MARK (LMFT)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:MARK
Last Name:BRENDZE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 205
Mailing Address - Street 2:
Mailing Address - City:BROOKLIN
Mailing Address - State:ME
Mailing Address - Zip Code:04616-0205
Mailing Address - Country:US
Mailing Address - Phone:415-424-2701
Mailing Address - Fax:
Practice Address - Street 1:39 OSPREY NEST LANE
Practice Address - Street 2:
Practice Address - City:BROOKLIN
Practice Address - State:ME
Practice Address - Zip Code:04616
Practice Address - Country:US
Practice Address - Phone:415-424-2701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP2500X, 106H00000X, 171400000X
CA33759106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171400000XOther Service ProvidersHealth & Wellness Coach