Provider Demographics
NPI:1285799411
Name:HOLLENBECK, BRENDA (MA, LPC, LMFT)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:
Last Name:HOLLENBECK
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W SALLIER ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5878
Mailing Address - Country:US
Mailing Address - Phone:337-436-6476
Mailing Address - Fax:
Practice Address - Street 1:833 HODGES ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-4247
Practice Address - Country:US
Practice Address - Phone:337-433-4357
Practice Address - Fax:337-433-9764
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2693101YP2500X
LA182106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist