Provider Demographics
NPI:1144029059
Name:MCBRYDE, LOEL (LPC)
Entity type:Individual
Prefix:
First Name:LOEL
Middle Name:
Last Name:MCBRYDE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LILY
Other - Middle Name:
Other - Last Name:MCBRYDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:114 S LELIA AVE
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75501-6972
Mailing Address - Country:US
Mailing Address - Phone:903-241-4322
Mailing Address - Fax:
Practice Address - Street 1:114 S LELIA AVE
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-6972
Practice Address - Country:US
Practice Address - Phone:903-241-4322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85714101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional