Provider Demographics
NPI:1992813489
Name:WILBANKS, BRENDA JOY (EDD, LPC, LMFT)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:JOY
Last Name:WILBANKS
Suffix:
Gender:
Credentials:EDD, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BRIERCROFT OFFICE PARK STE 10
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79412-3007
Mailing Address - Country:US
Mailing Address - Phone:806-767-9007
Mailing Address - Fax:
Practice Address - Street 1:22 BRIERCROFT OFFICE PARK STE 10
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-3007
Practice Address - Country:US
Practice Address - Phone:806-767-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9592101YP2500X
TX2956106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX025861801Medicaid