Healthcare Provider Details

I. General information

NPI: 1962322883
Provider Name (Legal Business Name): BRANT ALEXANDER MCCONNELL LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2938 NORTH AVE STE E
GRAND JUNCTION CO
81504-5797
US

IV. Provider business mailing address

1380 N 17TH ST
GRAND JUNCTION CO
81501-4316
US

V. Phone/Fax

Practice location:
  • Phone: 970-245-1616
  • Fax:
Mailing address:
  • Phone: 504-450-2947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0024092
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: