Provider Demographics
NPI:1003217308
Name:STORRER, PAULA NICHOLAS (MA, LPC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:NICHOLAS
Last Name:STORRER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-4321
Mailing Address - Country:US
Mailing Address - Phone:512-925-2412
Mailing Address - Fax:
Practice Address - Street 1:2404 W 8TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-4321
Practice Address - Country:US
Practice Address - Phone:512-925-2412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-06
Last Update Date:2014-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69215101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional