Provider Demographics
NPI:1588169494
Name:MOTLEY, BRANDI NICOLE (LPC)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:NICOLE
Last Name:MOTLEY
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 1:202 KENMORE DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-4954
Mailing Address - Country:US
Mailing Address - Phone:434-489-7447
Mailing Address - Fax:434-857-2078
Practice Address - Street 1:202 KENMORE DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4954
Practice Address - Country:US
Practice Address - Phone:434-489-7447
Practice Address - Fax:434-857-2078
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-25
Last Update Date:2018-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006817101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional