Provider Demographics
NPI:1053520718
Name:KAREN LEE BROCHUE, PC
Entity type:Organization
Organization Name:KAREN LEE BROCHUE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BROCHUE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT, LPC
Authorized Official - Phone:210-857-0140
Mailing Address - Street 1:PO BOX 781628
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-1628
Mailing Address - Country:US
Mailing Address - Phone:210-857-0410
Mailing Address - Fax:
Practice Address - Street 1:7570 KEENELAND DR
Practice Address - Street 2:
Practice Address - City:FAIR OAKS RANCH
Practice Address - State:TX
Practice Address - Zip Code:78015-4249
Practice Address - Country:US
Practice Address - Phone:210-857-0410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17153101YP2500X
TX4990106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty