Provider Demographics
NPI:1003124926
Name:BRAZINSKAS, PAUL JAMES (LCDC, QMHP)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JAMES
Last Name:BRAZINSKAS
Suffix:
Gender:M
Credentials:LCDC, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-4803
Mailing Address - Country:US
Mailing Address - Phone:432-686-2793
Mailing Address - Fax:432-570-3425
Practice Address - Street 1:401 E ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-4803
Practice Address - Country:US
Practice Address - Phone:432-686-2793
Practice Address - Fax:432-570-3425
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10205101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)