Brenda Interian-Boysselle, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

62135 Issued in TX

Practice address

1514 N Greenville Ave Ste 320
Allen, TX 75002-1207

Phone

(903) 372-0843

Fax

(469) 854-4998

NPI assigned

Aug 17, 2007

Last updated

Jul 31, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Brenda Patricia Interian-Martinez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1225221757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 BURL LN",
            "city": "ANNA",
            "state": "TX",
            "postal_code": "754094651",
            "telephone_number": "903-372-0843",
            "fax_number": "469-854-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 N GREENVILLE AVE STE 320",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750021207",
            "telephone_number": "903-372-0843",
            "fax_number": "469-854-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTERIAN-BOYSSELLE",
        "first_name": "BRENDA",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "62135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA HEALTHCARE SERVICES, TRICARE",
            "identifier": "1225221757",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187164201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "INTERIAN-MARTINEZ",
            "middle_name": "PATRICIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Allen, TX
• Providers in Allen, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.