Provider Demographics
NPI:1053139998
Name:ERDMAN, BRENNA (MSE, PLMHP)
Entity type:Individual
Prefix:
First Name:BRENNA
Middle Name:
Last Name:ERDMAN
Suffix:
Gender:F
Credentials:MSE, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 P ST APT 2H
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-1460
Mailing Address - Country:US
Mailing Address - Phone:308-737-0531
Mailing Address - Fax:
Practice Address - Street 1:610 J ST STE 220
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2967
Practice Address - Country:US
Practice Address - Phone:402-416-9415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14103101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health