Provider Demographics
NPI:1003272568
Name:FADYA PSYCHOTHERAPY
Entity Type:Organization
Organization Name:FADYA PSYCHOTHERAPY
Other - Org Name:FADYA ALBAKRY
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:FADYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBAKRY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCDC
Authorized Official - Phone:512-589-5897
Mailing Address - Street 1:3300 BEE CAVES RD
Mailing Address - Street 2:STE 650-183
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6600
Mailing Address - Country:US
Mailing Address - Phone:512-589-5897
Mailing Address - Fax:
Practice Address - Street 1:2525 WALLINGWOOD DR
Practice Address - Street 2:BLDG 7C
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6900
Practice Address - Country:US
Practice Address - Phone:512-589-5897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70192101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty