Provider Demographics
NPI:1164539417
Name:BOND, BRENDA STOCKTON (LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:STOCKTON
Last Name:BOND
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 E JONES ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102-2852
Mailing Address - Country:US
Mailing Address - Phone:361-542-4798
Mailing Address - Fax:361-542-4798
Practice Address - Street 1:804 E JONES ST APT 1
Practice Address - Street 2:
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-2852
Practice Address - Country:US
Practice Address - Phone:361-542-4798
Practice Address - Fax:361-542-4798
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19480101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7242LCOtherBLUE CROSS BLUE SHIELD
TX176629701Medicaid