Provider Demographics
NPI:1639261902
Name:BRANDT, STEPHANIE BRENNER (LPC AT LMFT CGP MS)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:BRENNER
Last Name:BRANDT
Suffix:
Gender:F
Credentials:LPC AT LMFT CGP MS
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:B
Other - Last Name:BRANDT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC AT LMFT CGP MS
Mailing Address - Street 1:PO BOX 820466
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77282-0466
Mailing Address - Country:US
Mailing Address - Phone:281-685-2199
Mailing Address - Fax:281-492-2751
Practice Address - Street 1:16300 KATY FWY STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1600
Practice Address - Country:US
Practice Address - Phone:281-685-2199
Practice Address - Fax:281-492-2751
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0042290042385106H00000X
TX09528101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1946LCOtherBCBS