Provider Demographics
NPI:1972723328
Name:BRINICH-LANGLOIS, HEATHER ELISE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:ELISE
Last Name:BRINICH-LANGLOIS
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 1:4603 MIDNIGHT WOODS ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-1817
Mailing Address - Country:US
Mailing Address - Phone:210-800-1711
Mailing Address - Fax:
Practice Address - Street 1:4603 MIDNIGHT WOODS ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-1817
Practice Address - Country:US
Practice Address - Phone:210-800-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53987101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKDA4442Medicaid