EDWIN BRENNAN, PHD, LP — NPI 1295196152 (Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Health Service in LEESVILLE, LA)

CMS-1500 Box 24J / 33a • NPI

1295196152

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103TH0100X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Health Service

Box 32 Service Location & ZIP+4

3353 UNIVERSITY PKWY, LEESVILLE, LA, 71446-9041

✓ 9-Digit EDI 837 ZIP+4 (71446-9041)

Practice Phone & Referral Fax

(337) 392-3800

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1295196152 (EDWIN BRENNAN, PHD, LP) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1295196152` (NPI-1 Individual Practitioner)
Provider / Legal Name	EDWIN BRENNAN, PHD, LP
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Health Service NUCC Code: `103TH0100X` (Psychologist, Health Service)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	3353 UNIVERSITY PKWY, LEESVILLE, LA, 71446-9041
Practice Telephone / Fax	Tel: (337) 392-3800
Administrative Mailing Address	FORT POLK VA OUTPATIENT CLINIC, LEESVILLE, LA 71446, LA, 71446
Enumeration & Last Sync	Enumerated: 2016-03-18 \| CMS Record Updated: 2022-09-27

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

3353 UNIVERSITY PKWY, LEESVILLE, LA, 71446-9041

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Plain-English Taxonomy & CMS Crosswalk (103TH0100X)

What Does Taxonomy Code 103TH0100X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103TH0100X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Health Service"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Psychologist, Health Service for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (EDWIN BRENNAN, PHD, LP)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101YM0800X` — Counselor, Mental Health Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: MI \| License: `6401014593` \| Primary: Secondary
`103TH0100X` — Psychologist, Health Service Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Health Service	State: LA \| License: `1544` \| Primary: Secondary
`103TH0100X` — Psychologist, Health Service Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Health Service	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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EDWIN BRENNAN, PHD, LP (NPI #1295196152)