Basic Information
| Provider Information | |||||||||
| NPI: | 1952894263 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOUNTS | ||||||||
| FirstName: | BRANDY | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | MED, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2904 SANTA ROSITA DR | ||||||||
| Address2: | |||||||||
| City: | ROUND ROCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786653411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127512611 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2851 JOE DIMAGGIO BLVD STE 7 | ||||||||
| Address2: | |||||||||
| City: | ROUND ROCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786653928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127632186 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2018 | ||||||||
| LastUpdateDate: | 02/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 76101 | TX | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | 76101 | TX | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.