Brenda Crellen, LMHC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

MH 11949 Issued in FL

Practice address

2020 Talley Rd
Leesburg, FL 34748-3426

Phone

(352) 315-7500

Fax

(352) 360-6582

NPI assigned

Aug 5, 2013

Last updated

Aug 5, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lifestream Behavioral Center Inc

  • Psychiatric Hospital
  • Leesburg, FL
  • NPI 1902802002
  NPD (past)

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1306278064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5511 BIRD ISLAND DR",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321594112",
            "telephone_number": "352-315-7500",
            "fax_number": "352-360-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 TALLEY RD",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483426",
            "telephone_number": "352-315-7500",
            "fax_number": "352-360-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRELLEN",
        "first_name": "BRENDA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "MH 11949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana N Cowles, DO
• June S Craft, APRN
• Marissa Crandall Cruz, D.M.D., M.S
• Madeline Cravens, MS
• Jeremy E Creech, A.R.N.P.
• Stephanie J Crenshaw
• Lisa Crigger, RBT-21-197635
• Carmen Lidya Cristobal, FNP
• Nancy Todd Cristoforo, M.D.
• Joseph Crogan

• Psychologist in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.