CLARA ELISA BRENNECKE


Address: 1122 W Hubbard St, Unit 3e, Chicago, IL 60642-8805
Phone: 3124052784

CLARA ELISA BRENNECKE (NPI# 1306391453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306391453
Entity Type Individual
Full Name CLARA ELISA BRENNECKE
Other Name CLARA ELISA BRENNECKE
Credential M.A. LCPC
Practice Address 1122 W Hubbard St
Unit 3e
Chicago
IL 60642-8805
Practice Telephone 3124052784
Enumeration Date 2016-08-18
Last Update Date 2018-03-16
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
180.010376 IL Behavioral Health & Social Service Providers

Office Location

Street Address 1122 W HUBBARD ST
UNIT 3E
City CHICAGO
State IL
Zip Code 60642-8805

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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City CHICAGO
Zip Code 60642

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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