Provider Demographics
NPI:1528405347
Name:LACE HISCOX, BRANDI (LCSW)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:LACE HISCOX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15803 CADE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-3753
Mailing Address - Country:US
Mailing Address - Phone:870-362-4033
Mailing Address - Fax:281-373-5202
Practice Address - Street 1:17510 HUFFMEISTER RD
Practice Address - Street 2:SUITE 103 & 105
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-6785
Practice Address - Country:US
Practice Address - Phone:281-658-3265
Practice Address - Fax:281-373-5202
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX621601041C0700X
AR6883-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical