Brenda-Joyce G Markert-Green, DMFT
Individual provider Active NPI Marriage & Family Therapist · South Bend, IN
NPI 1134315401 · NPPES record last updated Aug 11, 2022
Key facts
- NPI
- 1134315401
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 35001876A (IN)
- Practice address
- 5775 Nimtz Pkwy
South Bend, IN 46628-6194 - Phone
- (909) 503-7191
- NPI assigned
- Sep 20, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48104 | CA | MD | Marriage & Family Therapist |
| 35001876A | IN | MD | Marriage & Family Therapist |
| 4101006620 | MI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Afterglow Counseling, Mediation, and Family Services Centers | Counselor | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 48104 | CA | |
| Counselor | 101Y00000X | 48104 | CA | |
| Professional Counselor | 101YP2500X | 48104 | CA | |
| Clinical Neuropsychologist | 103G00000X | 48104 | CA | |
| Marriage & Family Therapist | 106H00000X | 4101006620 | MI | |
| Marriage & Family Therapist | 106H00000X | 48104 | CA | |
| Marriage & Family Therapist | 106H00000X | 35001876A | IN | Yes |
Addresses
Primary practice location
5775 Nimtz Pkwy
South Bend, IN 46628-6194
Mailing address
PO Box 24
Berrien Springs, MI 49103-0024
Phone (909) 503-7191
Other practice location 1
9067 US Highway 31 Ste 216
Berrien Springs, MI 49103-1685
Phone (909) 503-7191
Other providers in South Bend, IN
- Sarah Elizabeth Marchesseault
- John Philip Marchin
- David G Mark
- James M Mark
- Jason Eric Marker
- Laquishia L Markham
- Jon Christopher Markley
- Yesica Marquez
- Marquise & Chizanoe Transport LLC
- Jeana Marie Marren
All providers in South Bend, IN · Marriage & Family Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.