Provider Demographics
NPI:1831107630
Name:BRENTLINGER, MELISSA A (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:BRENTLINGER
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26859 KORNEGAY RD
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-8374
Mailing Address - Country:US
Mailing Address - Phone:956-361-3336
Mailing Address - Fax:866-366-4094
Practice Address - Street 1:26859 KORNEGAY RD
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-8374
Practice Address - Country:US
Practice Address - Phone:956-361-3336
Practice Address - Fax:866-366-4094
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11703101YP2500X
TX3367106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist