Provider Demographics
NPI:1356065957
Name:WEBB, BRANDI (SUDPT)
Entity type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:SUDPT
Other - Prefix:MS
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:BECKWITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SUDPT
Mailing Address - Street 1:1520 NE RIDDELL RD # 110
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3005
Mailing Address - Country:US
Mailing Address - Phone:360-228-7246
Mailing Address - Fax:
Practice Address - Street 1:1520 NE RIDDELL RD STE 110
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3005
Practice Address - Country:US
Practice Address - Phone:360-228-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61303390101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)