Provider Demographics
NPI:1225828452
Name:BRORMAN, BLAIRE MICHELLE (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:BLAIRE
Middle Name:MICHELLE
Last Name:BRORMAN
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9150 S COULTER ST APT 1423
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-5906
Mailing Address - Country:US
Mailing Address - Phone:806-670-5138
Mailing Address - Fax:
Practice Address - Street 1:625 DALLAS DR STE 100
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-7289
Practice Address - Country:US
Practice Address - Phone:940-395-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98811101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional