Provider Demographics
NPI:1528819869
Name:BRANDIE A. TERIFAJ, LISW-CP, LCSW, PLLC
Entity type:Organization
Organization Name:BRANDIE A. TERIFAJ, LISW-CP, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDIE
Authorized Official - Middle Name:ALISABETH
Authorized Official - Last Name:TERIFAJ
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP, LCSW
Authorized Official - Phone:301-471-3658
Mailing Address - Street 1:7004 WHITEWATER LOOP
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:NC
Mailing Address - Zip Code:28098-0017
Mailing Address - Country:US
Mailing Address - Phone:301-471-3658
Mailing Address - Fax:
Practice Address - Street 1:3117 WHITING AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-1648
Practice Address - Country:US
Practice Address - Phone:301-471-3658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty