Provider Demographics
NPI:1871374959
Name:TARZIS, BRANDON A (LMHC)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:A
Last Name:TARZIS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SAINT PAULS PL APT 3D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1372
Mailing Address - Country:US
Mailing Address - Phone:614-537-1095
Mailing Address - Fax:
Practice Address - Street 1:623 BROADWAY FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2698
Practice Address - Country:US
Practice Address - Phone:646-516-9818
Practice Address - Fax:212-929-9727
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-13
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017112101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty