Provider Demographics
NPI:1467297994
Name:ACEVEDO, BRENDA (LPC)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:ACEVEDO
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 1:12370 POTRANCO RD
Mailing Address - Street 2:SUITE 207 NUMBER 230
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-4260
Mailing Address - Country:US
Mailing Address - Phone:210-920-1714
Mailing Address - Fax:
Practice Address - Street 1:12370 POTRANCO RD
Practice Address - Street 2:SUITE 207 NUMBER 230
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-4260
Practice Address - Country:US
Practice Address - Phone:210-920-1714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90149101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health