Provider Demographics
NPI:1063503761
Name:MORRIS, BRENDA A (LPC)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:A
Last Name:MORRIS
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 1:3617 BROADWAY BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1663
Mailing Address - Country:US
Mailing Address - Phone:972-278-1590
Mailing Address - Fax:972-278-1590
Practice Address - Street 1:3617 BROADWAY BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1663
Practice Address - Country:US
Practice Address - Phone:972-278-1590
Practice Address - Fax:972-278-1590
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12293101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health