Brenda Jaffe, LCSW-C, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

13482 Issued in MD

Legal business name

BRENDA JAFFE, LCSW-C, LLC

Practice address

100 Bourbon St
Havre de Grace, MD 21078-3147

Phone

(410) 939-9339

Fax

(410) 497-1104

NPI assigned

Dec 16, 2010

Last updated

Dec 16, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brenda H.G. Jaffe, LCSW-CNPI 1982622866

Title

Proprietor, Therapist

Phone

(302) 242-1028

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brenda H. G. Jaffe, LCSW-C

  • Clinical Social Worker
  • Havre de Grace, MD
  • NPI 1982622866
  Authorized official Same address or phone

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292457600000",
    "number": "1760785521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 835",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210780835",
            "telephone_number": "302-242-1028",
            "fax_number": "410-497-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BOURBON ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783147",
            "telephone_number": "410-939-9339",
            "fax_number": "410-497-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENDA JAFFE, LCSW-C, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-16",
        "last_updated": "2010-12-16",
        "status": "A",
        "authorized_official_last_name": "JAFFE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "H.G.",
        "authorized_official_title_or_position": "PROPRIETOR, THERAPIST",
        "authorized_official_telephone_number": "302-242-1028",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "13482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15O4O3701",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonya Anitra Bowens, PMHNP-BC
• Sakeena Jentae Bowman, COTA/L
• Debbie L Boyd, CRNP
• Kelly Bragg, LCPC
• John S Braxton III, P.A.
• Brian C. de Muth M.D., PA (Chesapeake Sports & Orthopaedics)
• Brian C. de Muth, M.D., PA (Chesapeake Sports & Orthopaedics)
• Jessica Tierra Bridges
• Bright Minds Therapy, LLC
• Nicole Jasmyn Bright, DO

• Community/Behavioral Health Agency in Havre de Grace, MD
• Providers in Havre de Grace, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.