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NPI Code Detail

MEDICARE: BRENDAUL LYBBERT

MEDICARE: BRENDAUL LYBBERT
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
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1083565980
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDAUL LYBBERT
Provider Business Mailing Address
First Line : 1401 MINTER RD
Second Line :
City : PLANO
State : TX
Zip : 75023-1909
Country : US
Telephone Number : 817-235-2484
Fax Number :
Provider Business Practice Location Address
First Line : 618 CLARA BARTON BLVD STE 7
Second Line :
City : GARLAND
State : TX
Zip : 75042-5731
Country : US
Telephone Number : 972-382-5779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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Directions to “ BRENDAUL LYBBERT ” Practice Location

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