Provider Demographics
NPI:1003605155
Name:RODGERS, BRIANNE (LPC-A)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:RODGERS
Suffix:
Gender:
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 N HULGAN CIR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-5301
Mailing Address - Country:US
Mailing Address - Phone:972-741-8866
Mailing Address - Fax:
Practice Address - Street 1:8310 SOUTHWESTERN BLVD APT 522
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-1504
Practice Address - Country:US
Practice Address - Phone:972-741-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health