Provider Demographics
NPI:1821364605
Name:LOPEZ, BRENDA MARIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:MARIE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:BRENDA
Other - Middle Name:SLAVINSKI
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:2117 AVENUE I
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2641
Mailing Address - Country:US
Mailing Address - Phone:832-492-8598
Mailing Address - Fax:281-762-1322
Practice Address - Street 1:2117 AVENUE I
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2641
Practice Address - Country:US
Practice Address - Phone:281-498-4673
Practice Address - Fax:281-342-8943
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65884101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional