Provider Demographics
NPI:1548859408
Name:PORCHE, BRANDY (LPC)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:PORCHE
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 1:6401 ELDORADO PKWY STE 117
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-6147
Mailing Address - Country:US
Mailing Address - Phone:630-363-7982
Mailing Address - Fax:
Practice Address - Street 1:6401 ELDORADO PKWY STE 117
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-6147
Practice Address - Country:US
Practice Address - Phone:630-363-7982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82988101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional