Provider Demographics
NPI:1730380387
Name:HANSEN-MAYER, BRENDA (LPC)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:HANSEN-MAYER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E 69TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-8322
Mailing Address - Country:US
Mailing Address - Phone:605-330-9997
Mailing Address - Fax:605-330-9998
Practice Address - Street 1:1601 E 69TH ST STE 202
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8322
Practice Address - Country:US
Practice Address - Phone:605-330-9997
Practice Address - Fax:605-330-9998
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC1130101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional