Provider Demographics
NPI:1336296524
Name:LEIBER, BRENDA (MA, LPC, LPA)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:LEIBER
Suffix:
Gender:F
Credentials:MA, LPC, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1205
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77497-1205
Mailing Address - Country:US
Mailing Address - Phone:281-491-4455
Mailing Address - Fax:281-491-3565
Practice Address - Street 1:4800 SUGAR GROVE BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2635
Practice Address - Country:US
Practice Address - Phone:281-491-4455
Practice Address - Fax:281-491-3565
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health