Active NPI
Brenda L Spina, BRENDA SPINA, M.S.
- Marriage & Family Therapist
- Menasha, WI
National Provider Identifier
1063676658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 136-124
- Practice address
- 1476 Kenwood Ctr
Menasha, WI 54952-1134 - Phone
- (920) 720-8872
- Fax
- (920) 720-8873
- NPI assigned
- Jul 14, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 520-125 | WI | |
| Marriage & Family Therapist | 106H00000X | 136-124 | WI | Primary |
Addresses
Primary practice location
1476 Kenwood Ctr
Menasha, WI 54952-1134
Mailing address
1476 Kenwood Ctr
Menasha, WI 54952-1134
Phone (920) 720-8872
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 520-125 | WI | MD | Professional Counselor |
| 136-124 | WI | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215993600000",
"number": "1063676658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1476 KENWOOD CTR",
"city": "MENASHA",
"state": "WI",
"postal_code": "549521134",
"telephone_number": "920-720-8872",
"fax_number": "920-720-8873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1476 KENWOOD CTR",
"city": "MENASHA",
"state": "WI",
"postal_code": "549521134",
"telephone_number": "920-720-8872",
"fax_number": "920-720-8873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPINA",
"first_name": "BRENDA",
"middle_name": "L",
"credential": "BRENDA SPINA, M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-14",
"last_updated": "2008-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "520-125",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WI",
"license": "136-124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menasha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.