Provider Demographics
NPI:1679239883
Name:GRISSETT, BRANDEE (LPC)
Entity type:Individual
Prefix:
First Name:BRANDEE
Middle Name:
Last Name:GRISSETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604A COMANCHE ST
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2268
Mailing Address - Country:US
Mailing Address - Phone:979-324-6023
Mailing Address - Fax:
Practice Address - Street 1:1804 BROTHERS BLVD STE A
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-5474
Practice Address - Country:US
Practice Address - Phone:979-324-6023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82285101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health