Heather Renae Brogan-McCarty, LPC
Individual provider Active NPI Counselor · Granbury, TX
NPI 1164435459 · NPPES record last updated Jan 24, 2023
Key facts
- NPI
- 1164435459
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 18825 (TX)
- Practice address
- 1016 W Pearl St
Granbury, TX 76048-1866 - Phone
- (817) 279-7311
- NPI assigned
- Aug 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18825 | TX | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 18825 | TX | |
| Counselor | 101Y00000X | 18825 | TX | Yes |
Addresses
Primary practice location
1016 W Pearl St
Granbury, TX 76048-1866
Mailing address
PO Box 904
Granbury, TX 76048-0904
Phone (817) 279-7311
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1641813-01 | Medicaid | TX |
Other providers in Granbury, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.