Provider Demographics
NPI:1225338759
Name:FENBERG, BRIAN GREGORY (LMFT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:GREGORY
Last Name:FENBERG
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 PINE NEEDLE LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5521
Mailing Address - Country:US
Mailing Address - Phone:281-798-2088
Mailing Address - Fax:
Practice Address - Street 1:2121 MARKET ST
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-1689
Practice Address - Country:US
Practice Address - Phone:281-798-2088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201174106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist