Brenna Marie Nicholson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

001919 Issued in CT

Practice address

408 Highland Ave
BLDG a, Suite 6
Cheshire, CT 06410-2525

Phone

(203) 494-9030

NPI assigned

Nov 30, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Brenna Marie Dobos Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1982906715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGHLAND AVE",
            "address_2": "BLDG A, SUITE 6",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102525",
            "telephone_number": "203-494-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 HIGHLAND AVE",
            "address_2": "BLDG A, SUITE 6",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102525",
            "telephone_number": "203-494-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "BRENNA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-30",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001919",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "001919",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENNA",
            "last_name": "DOBOS",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Cheshire, CT
• Providers in Cheshire, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.