Jeffrey G. Brenneman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20020001381 Issued in MO

Practice address

12400 Olive Blvd
Suite 205
Saint Louis, MO 63141-5454

Phone

(314) 910-8608

Fax

(314) 910-8608

NPI assigned

Jul 27, 2006

Last updated

Jul 23, 2010By the provider in NPPES

Sex

Male

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)

Enrolled

State licenses

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279843200000",
    "number": "1669496055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CHERRI LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631324103",
            "telephone_number": "314-910-8608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 OLIVE BLVD",
            "address_2": "SUITE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415454",
            "telephone_number": "314-910-8608",
            "fax_number": "314-910-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNEMAN",
        "first_name": "JEFFREY",
        "middle_name": "G.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2010-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "20020001381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Xavier Brennan, M.D.
• Robert Alexis Brennan, M.D.
• Steven K Brennan, MD
• Melissa Brennecke
• Miranda Lynn Brennecke, LCSW
• Christopher James Brenner, DO
• Jay Allan Brenner, M.D.
• Kathryn Brenner, NNP-BC
• Lisa M. Brenner, PSYCHOLOGIST
• Madeline Brenner

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; 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.