Provider Demographics
NPI:1407136294
Name:BRUMLEY, PATRICE (LPC)
Entity Type:Individual
Prefix:MS
First Name:PATRICE
Middle Name:
Last Name:BRUMLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8956 RESEARCH BLVD
Mailing Address - Street 2:BLDG. 2
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5902
Mailing Address - Country:US
Mailing Address - Phone:512-451-7337
Mailing Address - Fax:512-451-8729
Practice Address - Street 1:8956 RESEARCH BLVD
Practice Address - Street 2:BLDG. 2
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5902
Practice Address - Country:US
Practice Address - Phone:512-451-7337
Practice Address - Fax:512-451-8729
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB2495OtherBIOFEEDBACK CERTIFICATION INTERNATIONAL ALLIANCE