MEDICARE: MRS. BRANDI ALEECE OWNBY M.S., LPC

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	101YP2500X	Professional Counselor	63043	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225367303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRANDI ALEECE OWNBY M.S., LPC

Provider Business Mailing Address
First Line	:	2300 CIRCLE DR
Second Line	:	STE 2307
City	:	FORT WORTH
State	:	TX
Zip	:	76119-8134
Country	:	US
Telephone Number	:	817-349-8787
Fax Number	:	817-231-0650

Provider Business Practice Location Address
First Line	:	2300 CIRCLE DR
Second Line	:	STE 2307
City	:	FORT WORTH
State	:	TX
Zip	:	76119-8134
Country	:	US
Telephone Number	:	817-349-8787
Fax Number	:	817-231-0650

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

Provider Enumeration Date	:	12/18/2009
Last Update Date	:	06/12/2024

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