Provider Demographics
NPI:1437735263
Name:DEAMER, BRANDON (LPC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:DEAMER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 RIDGEDALE DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5615
Mailing Address - Country:US
Mailing Address - Phone:717-808-6215
Mailing Address - Fax:
Practice Address - Street 1:613 RIDGEDALE DR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5615
Practice Address - Country:US
Practice Address - Phone:717-808-6215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67088101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67088OtherTEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL