Provider Demographics
NPI:1467765206
Name:MANDEL, NAOMI BROOKE (LMFT, LPC)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:BROOKE
Last Name:MANDEL
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 S MAIN ST
Mailing Address - Street 2:SUITE #111
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-3332
Mailing Address - Country:US
Mailing Address - Phone:830-446-3355
Mailing Address - Fax:
Practice Address - Street 1:1430 S MAIN ST
Practice Address - Street 2:SUITE #111
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3332
Practice Address - Country:US
Practice Address - Phone:830-446-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62911101YP2500X
TX201071106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional