MEDICARE: MS. ELAINE LOVE BRANDON LPC-S

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	14810	TX
2	101YP2500X	Professional Counselor	14810	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	:	1467571034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELAINE LOVE BRANDON LPC-S

Provider Business Mailing Address
First Line	:	308 S FRIENDSWOOD DR STE 200
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-3989
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 W SUNSET RD STE 400
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1772
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	12/09/2024

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