Provider Demographics
NPI:1558781815
Name:PARKER, BRENDA LUCILLE (NCC, LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:LUCILLE
Last Name:PARKER
Suffix:
Gender:F
Credentials:NCC, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10004 SUNNY SIDE LN
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-5370
Mailing Address - Country:US
Mailing Address - Phone:254-493-3152
Mailing Address - Fax:
Practice Address - Street 1:10004 SUNNY SIDE LN
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-5370
Practice Address - Country:US
Practice Address - Phone:254-493-3152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11087101YP2500X
TX333550101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional