Bran New Genesis Counseling Service, PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

69749 Issued in TX

Legal business name

BRAN NEW GENESIS COUNSELING SERVICE, PLLC

Practice address

11623 Oak Lake Park Dr
Sugar Land, TX 77498-7010

Phone

(800) 905-1240

NPI assigned

Dec 15, 2015

Last updated

Dec 15, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brandelyn L Green, LPC

Title

LPC Therapy

Phone

(800) 905-1240

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450137600000",
    "number": "1477918647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11623 OAK LAKE PARK DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774987010",
            "telephone_number": "800-905-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11623 OAK LAKE PARK DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774987010",
            "telephone_number": "800-905-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAN NEW GENESIS COUNSELING SERVICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-15",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "BRANDELYN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LPC THERAPY",
        "authorized_official_telephone_number": "800-905-1240",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "68759",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "68759",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "69749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; 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.