Organization
BRAN NEW GENESIS COUNSELING SERVICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDELYN L GREEN LPC (LPC THERAPY)
(800) 905-1240
Entity
Organization
Contact information
Practice address
11623 OAK LAKE PARK DR, SUGAR LAND, TX 77498-7010
(800) 905-1240
Mailing address
11623 OAK LAKE PARK DR, SUGAR LAND, TX 77498-7010
(800) 905-1240
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
68759
TX
101YM0800X
Mental Health Counselor
68759
TX
101YP2500X
Professional Counselor
Primary
69749
TX
Other
Enumeration date
12/15/2015
Last updated
12/15/2015
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