MEDICARE: BRILLIANT CREATIONS COUNSELING PLLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1053275842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRILLIANT CREATIONS COUNSELING PLLC

Provider Business Mailing Address
First Line	:	3921 LONG PRAIRIE RD
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-1571
Country	:	US
Telephone Number	:	940-448-0487
Fax Number	:

Provider Business Practice Location Address
First Line	:	3921 LONG PRAIRIE RD
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-1571
Country	:	US
Telephone Number	:	940-448-0487
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	JENNIFER DOUGLASS
Credential	:
Telephone Number	:	940-448-0487

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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