Provider Demographics
NPI:1114701802
Name:BRYSCH, ANTHONY FRANK (LPC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:FRANK
Last Name:BRYSCH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8602 NE ZAC LENTZ PKWY APT 429
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3145
Mailing Address - Country:US
Mailing Address - Phone:830-534-7961
Mailing Address - Fax:
Practice Address - Street 1:8602 NE ZAC LENTZ PKWY APT 429
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3145
Practice Address - Country:US
Practice Address - Phone:830-534-7961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84829101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional