Provider Demographics
NPI:1043546898
Name:CHIARELLO, BRANDI MICHELLE (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:MICHELLE
Last Name:CHIARELLO
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:MISS
Other - First Name:BRANDI
Other - Middle Name:MICHELLE
Other - Last Name:HOLLIDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:13151 EMILY RD
Mailing Address - Street 2:STE 109
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-8989
Mailing Address - Country:US
Mailing Address - Phone:469-321-6006
Mailing Address - Fax:
Practice Address - Street 1:13151 EMILY RD
Practice Address - Street 2:STE 109
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-8989
Practice Address - Country:US
Practice Address - Phone:469-321-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-29
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63436101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional