Bernadette Leilani Brennecke, LSCW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LG 10677 Issued in CA

Practice address

4574 Live Oak Canyon Rd
La Verne, CA 91750-2312

Phone

(909) 263-0851

Fax

(626) 338-9022

NPI assigned

Apr 10, 2007

Last updated

Feb 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bernadette L. Brennecke, LCSW, Inc.

  • Mental Health Counselor
  • La Verne, CA
  • NPI 1902121940
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1275756017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S SUNSET AVE STE 102",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902808",
            "telephone_number": "909-263-0851",
            "fax_number": "626-338-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4574 LIVE OAK CANYON RD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502312",
            "telephone_number": "909-263-0851",
            "fax_number": "626-338-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNECKE",
        "first_name": "BERNADETTE",
        "middle_name": "LEILANI",
        "name_prefix": "Ms.",
        "credential": "LSCW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LG 10677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE NUMBER",
            "identifier": "M0990601",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Osama Boules
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• Kristine Bravo
• Brethren Hillcrest Homes (Woods Health Services)
• Brittany Anne Burkhart
• Melvin Franklin Brooks, MSPT
• Kaylee J Buck
• Dale Leroy Buckwalter, OD

• Clinical Social Worker in La Verne, CA
• Providers in La Verne, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.