Provider Demographics
NPI:1033663554
Name:CORTEZ, SARAH (MS, LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4107 MEDICAL PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3729
Mailing Address - Country:US
Mailing Address - Phone:512-662-5934
Mailing Address - Fax:
Practice Address - Street 1:4107 MEDICAL PKWY STE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3729
Practice Address - Country:US
Practice Address - Phone:512-662-5934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13106101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional