Provider Demographics
NPI:1073018412
Name:SMITH, BRANDEE R (LPC, LCDC)
Entity Type:Individual
Prefix:MS
First Name:BRANDEE
Middle Name:R
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13706 RESEARCH BLVD STE 312
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1840
Mailing Address - Country:US
Mailing Address - Phone:512-900-3415
Mailing Address - Fax:
Practice Address - Street 1:13706 RESEARCH BLVD STE 312
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1840
Practice Address - Country:US
Practice Address - Phone:512-900-3415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75078101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health