Provider Demographics
NPI:1013190818
Name:DEYOUNG, ANN MARIE (LMHC, LCSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:DEYOUNG
Suffix:
Gender:F
Credentials:LMHC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 E BEN WHITE BLVD STE 240-8949
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-6966
Mailing Address - Country:US
Mailing Address - Phone:737-444-5980
Mailing Address - Fax:
Practice Address - Street 1:2028 E BEN WHITE BLVD STE 240-8949
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-6966
Practice Address - Country:US
Practice Address - Phone:737-444-5980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00973101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA71364OtherWELLMARK BCBS