Provider Demographics
NPI:1083916522
Name:TARVER, BRANDI LYNN (LPC)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:LYNN
Last Name:TARVER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18333 EGRET BAY BLVD STE 580
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3266
Mailing Address - Country:US
Mailing Address - Phone:281-219-9020
Mailing Address - Fax:281-480-0202
Practice Address - Street 1:18333 EGRET BAY BLVD STE 580
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3266
Practice Address - Country:US
Practice Address - Phone:281-219-9020
Practice Address - Fax:281-480-0202
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64924101YP2500X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional