Provider Demographics
NPI:1982384509
Name:BRAWLEY, SAMANTHA LOUANN (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:LOUANN
Last Name:BRAWLEY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MISS
Other - First Name:SAMANTHA
Other - Middle Name:LOUANN
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7980 ANCHOR DR STE 500
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-8285
Mailing Address - Country:US
Mailing Address - Phone:409-727-6400
Mailing Address - Fax:409-727-6403
Practice Address - Street 1:7980 ANCHOR DR STE 500
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-8285
Practice Address - Country:US
Practice Address - Phone:409-727-6400
Practice Address - Fax:409-727-6403
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82114101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional