Mary Brandon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1016 Issued in TN

Practice address

Blanchfield Army Community Hospital
650 Joel Drive
Fort Campbell, KY 42223-5349

Phone

(270) 798-8400

Fax

(270) 956-0180

NPI assigned

Feb 11, 2008

Last updated

Feb 11, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1801064001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
            "address_2": "650 JOEL DRIVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235349",
            "telephone_number": "270-798-8400",
            "fax_number": "270-956-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
            "address_2": "650 JOEL DRIVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235349",
            "telephone_number": "270-798-8400",
            "fax_number": "270-956-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "1016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "VAD000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Racheal Brady, EFDA
• Jonathan Brainard, MS, RD, CSSD, CSCS
• Nonie Leah Bramel, R.N.
• Paris Monique Branch
• Jason Andrew Brandi, PT
• Rodney Kenneth Brannan, AU.D.
• Katrina L Bratton, PH.D.
• Stephanie Jill Braverman, MD
• Noah Brayton, DDS
• Monta Annette Breeden, LCSW LMT

• Clinical Social Worker in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.