Provider Demographics
NPI:1083916522
Name:TARVER, BRANDI LYNN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:LYNN
Last Name:TARVER
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 1:1560 W BAY AREA BLVD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-2667
Mailing Address - Country:US
Mailing Address - Phone:281-480-0200
Mailing Address - Fax:281-480-0202
Practice Address - Street 1:1560 W BAY AREA BLVD
Practice Address - Street 2:SUITE 270
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-2667
Practice Address - Country:US
Practice Address - Phone:281-480-0200
Practice Address - Fax:281-480-0202
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64924101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional