Active NPI
Brent Phillip Brendle, M.S. L.P.C.
- Professional Counselor
- Southampton, NJ
National Provider Identifier
1538506449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00389500
- Practice address
- 63 Main St
Southampton, NJ 08088-8869 - Phone
- (609) 755-5680
- NPI assigned
- May 31, 2013
- Last updated
- May 31, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37PC00389500 | NJ | Primary |
Addresses
Primary practice location
63 Main St
Southampton, NJ 08088-8869
Mailing address
PO Box 2383
Southampton, NJ 08088-2383
Phone (609) 755-5680
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0400526582 | Medicaid | NJ |
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 |
|---|---|---|---|
| 37PC00389500 | NJ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369958400000",
"number": "1538506449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2383",
"city": "SOUTHAMPTON",
"state": "NJ",
"postal_code": "080882383",
"telephone_number": "609-755-5680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 MAIN ST",
"city": "SOUTHAMPTON",
"state": "NJ",
"postal_code": "080888869",
"telephone_number": "609-755-5680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENDLE",
"first_name": "BRENT",
"middle_name": "PHILLIP",
"credential": "M.S. L.P.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-31",
"last_updated": "2013-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00389500",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0400526582",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southampton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.