Provider Demographics
NPI:1740325174
Name:BURANDT, BRIDGET ANNE (LPC)
Entity type:Individual
Prefix:MS
First Name:BRIDGET
Middle Name:ANNE
Last Name:BURANDT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5909 WEST LOOP S STE 470
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2493
Mailing Address - Country:US
Mailing Address - Phone:713-664-5512
Mailing Address - Fax:713-664-5523
Practice Address - Street 1:5909 WEST LOOP S STE 470
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2493
Practice Address - Country:US
Practice Address - Phone:713-664-5512
Practice Address - Fax:713-664-5523
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19439101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL254800OtherCOMPSYCH FOR BELLAIRE OFF
IL258894OtherCOMPSYCH FOR KINGWOOD OFF
TX7107LCOtherBCBSTX
CA5679981OtherFIRST HEALTH
NJ9402244OtherPHCS