Maurya R Brenneman, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10589 Issued in MD

Practice address

3300 Arapahoe Ave Ste 218
Boulder, CO 80303-1044

Phone

(301) 385-1591

NPI assigned

Mar 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630886400000",
    "number": "1700916681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18462",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803081462",
            "telephone_number": "301-385-1591",
            "fax_number": "301-385-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 ARAPAHOE AVE STE 218",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031044",
            "telephone_number": "301-385-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNEMAN",
        "first_name": "MAURYA",
        "middle_name": "R",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2021-09-06",
        "certification_date": "2021-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09925306",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09925306",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison C Breed, MSW
• Gertie Breffle, MA, LPC
• Kidd J Brehm
• Alison Bremner, D.C
• Lee K Brennan, PT
• Debra Brenner
• Laura Bressler, LAC
• Brett Astor Counseling, PLLC
• Brian Kim LLC
• Brian P Gradisek DPM PLLC

• Clinical Social Worker in Boulder, CO
• Providers in Boulder, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.