Healthcare Provider Details

I. General information

NPI: 1518635465
Provider Name (Legal Business Name): BRANDI L. SINCLAIR, LPC, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2021
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5910 N CENTRAL EXPY STE 1820
DALLAS TX
75206-0946
US

IV. Provider business mailing address

5910 N CENTRAL EXPY STE 1820
DALLAS TX
75206-0946
US

V. Phone/Fax

Practice location:
  • Phone: 214-363-2345
  • Fax: 469-716-5053
Mailing address:
  • Phone: 214-363-2345
  • Fax: 469-716-5053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM SINCLAIR
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 469-680-3630