Provider Demographics
NPI:1790020246
Name:GOINS, BRANDY A (MS, LPC, LSOTP)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:A
Last Name:GOINS
Suffix:
Gender:F
Credentials:MS, LPC, LSOTP
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:A
Other - Last Name:WHITEHEAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2348 CR 2525
Mailing Address - Street 2:
Mailing Address - City:ALTO
Mailing Address - State:TX
Mailing Address - Zip Code:75925-3910
Mailing Address - Country:US
Mailing Address - Phone:318-315-0929
Mailing Address - Fax:318-256-2064
Practice Address - Street 1:103 WILDLIFE LANE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904
Practice Address - Country:US
Practice Address - Phone:936-238-3868
Practice Address - Fax:936-238-3867
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79250101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty