Shanda Marie Brennan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

92487 Issued in CA

Practice address

26625 Emperor Rd
Menifee, CA 92585-3218

Phone

(951) 640-2930

NPI assigned

Nov 9, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Let It Be Therapy & Counseling Services, a Licensed Clinical Social Worker Corp

  • Mental Health Counselor
  • Temecula, CA
  • NPI 1457158313
  NPD Authorized official

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

{
    "created_epoch": "1573257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1396380770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26625 EMPEROR RD",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925853218",
            "telephone_number": "951-640-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26625 EMPEROR RD",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925853218",
            "telephone_number": "951-640-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "SHANDA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-09",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "92487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anita Bradley
• Brainwaves Pediatric Therapy Inc
• Donna Marie Branch, MA, LMFT, CADC-II
• Victoria Elizabeth Brannon
• Alexis Jazmyn Brathwaite
• Shawn Marie Briggs, LCSW
• Monica Brittingham
• Evelyn Kate Brixey, BS
• Rachel M Brooks, P.T., DPT
• Carl Albert Brown, RN

• Clinical Social Worker in Menifee, CA
• Providers in Menifee, 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 Nov 1, 2021; 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.