Maria A Sandra Brady, LPC

Individual provider Active NPI Professional Counselor · Bastrop, TX

NPI 1225296304 · NPPES record last updated May 27, 2008

Key facts

NPI
1225296304
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
61478 (TX)
Practice address
1011 Alley a St
Bastrop, TX 78602-3240
Phone
(512) 797-0109
NPI assigned
May 27, 2008
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

LicenseStateTypeSpecialty
61478TXMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 61478 TX Yes

Addresses

Primary practice location

1011 Alley a St
Bastrop, TX 78602-3240

Mailing address

219 Kona Dr
Bastrop, TX 78602-4637
Phone (512) 797-0109

Other providers in Bastrop, TX

All providers in Bastrop, TX · Professional Counselor in Texas

Sources for this page

Verify at the official NPI Registry.