MEDICARE: BREE ANNE HENDRIX-PEART LPC, 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	101YP2500X	Professional Counselor	15883	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841300282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREE ANNE HENDRIX-PEART LPC, LMFT

Provider Business Mailing Address
First Line	:	PO BOX 361
Second Line	:
City	:	BOERNE
State	:	TX
Zip	:	78006-0361
Country	:	US
Telephone Number	:	210-685-5599
Fax Number	:

Provider Business Practice Location Address
First Line	:	4243 E PIEDRAS DR STE 100
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1416
Country	:	US
Telephone Number	:	210-685-5599
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	06/22/2010

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