MEDICARE: BRANDI K STURROCK LCSW-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	171M00000X	Case Manager/Care Coordinator	35644	TX
3	1041C0700X	Clinical Social Worker	35644	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	35644	OTHER	TX	LCSW LICENSE

General Provider Information

NPI Number	:	1295031672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI K STURROCK LCSW-S

Provider Business Mailing Address
First Line	:	611 ROCKMEAD DR STE 100
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-2294
Country	:	US
Telephone Number	:	855-204-2767
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 ROCKMEAD DR STE 100
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-2294
Country	:	US
Telephone Number	:	855-204-2767
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2011
Last Update Date	:	06/05/2025

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