Provider Demographics
NPI:1245463470
Name:HOPPE, BRIAN J (LPC-S)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:J
Last Name:HOPPE
Suffix:
Gender:M
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5620 SW GREEN OAKS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-1160
Mailing Address - Country:US
Mailing Address - Phone:817-569-4393
Mailing Address - Fax:
Practice Address - Street 1:5620 SW GREEN OAKS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1160
Practice Address - Country:US
Practice Address - Phone:817-205-2706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-04
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX205084101Medicaid