| Bran New Genesis Counseling Service, Pllc | |
|
11623 Oak Lake Park Dr Sugar Land TX 77498-7010 | |
| (800) 905-1240 | |
| Not Available |
| Full Name | Bran New Genesis Counseling Service, Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 11623 Oak Lake Park Dr, Sugar Land, Texas |
| Authorized Official Name and Position | Brandelyn L Green (LPC THERAPY) |
| Authorized Official Contact | 8009051240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bran New Genesis Counseling Service, Pllc 11623 Oak Lake Park Dr Sugar Land TX 77498-7010 Ph: (800) 905-1240 | Bran New Genesis Counseling Service, Pllc 11623 Oak Lake Park Dr Sugar Land TX 77498-7010 Ph: (800) 905-1240 |
| NPI Number | 1477918647 |
|---|---|
| Provider Enumeration Date | 12/15/2015 |
| Last Update Date | 12/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477918647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 68759 (Texas) | Secondary |
| 101YM0800X | Counselor - Mental Health | 68759 (Texas) | Secondary |
| 101YP2500X | Counselor - Professional | 69749 (Texas) | Primary |
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