Active NPI
Brenda Renee Logan, LMFT, CEAP
- Mental Health Counselor
- Gardena, CA
National Provider Identifier
1558544635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MFT 45015
- Practice address
- 1225 W 190TH St
Suite 310
Gardena, CA 90248-4320 - Phone
- (323) 753-7763
- Fax
- (310) 538-5518
- NPI assigned
- Dec 11, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MFT 45015 | CA | Primary |
Addresses
Primary practice location
1225 W 190TH St
Suite 310
Gardena, CA 90248-4320
Mailing address
PO Box 513283
Los Angeles, CA 90051-1283
Phone (323) 791-8305
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT 45015 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1558544635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 513283",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900511283",
"telephone_number": "323-791-8305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 W 190TH ST",
"address_2": "SUITE 310",
"city": "GARDENA",
"state": "CA",
"postal_code": "902484320",
"telephone_number": "323-753-7763",
"fax_number": "310-538-5518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "BRENDA",
"middle_name": "RENEE",
"name_prefix": "Miss",
"credential": "LMFT, CEAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-11",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "MFT 45015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.