MEDICARE: BRENDA BRIDGES LMFT

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	106H00000X	Marriage & Family Therapist	203706	TX
3	106H00000X	Marriage & Family Therapist		CA
4	106H00000X	Marriage & Family Therapist	111243	CA
5	106H00000X	Marriage & Family Therapist
6	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1033454343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA BRIDGES LMFT

Provider Business Mailing Address
First Line	:	2300 SCENIC DR STE 1322
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-7705
Country	:	US
Telephone Number	:	512-955-2052
Fax Number	:

Provider Business Practice Location Address
First Line	:	1113 MOONLIGHT TERRACE DR
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78628-2966
Country	:	US
Telephone Number	:	512-791-7401
Fax Number	:

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

Provider Enumeration Date	:	11/28/2012
Last Update Date	:	03/17/2026

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Directions to “ BRENDA BRIDGES LMFT” Practice Location

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