Organization
BRENT WHEELER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT WAYNE WHEELER MA (LPC, LSSP, LPA)
(512) 786-0467
Entity
Organization
Contact information
Practice address
1907 N. LAMAR BLVD, SUITE 354, AUSTIN, TX 78705
(512) 786-0467
(254) 519-3464
Mailing address
2300 E. 8TH ST., AUSTIN, TX 78702
(512) 512-7860
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15744
TX
101YP2500X
Professional Counselor
—
—
103TS0200X
School Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5301LC
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
04/20/2009
Last updated
04/20/2009
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