Provider Demographics
NPI:1093113615
Name:MAASE, LORETTA (MA, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:LORETTA
Middle Name:
Last Name:MAASE
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163452
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78716-3452
Mailing Address - Country:US
Mailing Address - Phone:512-897-8777
Mailing Address - Fax:512-584-8106
Practice Address - Street 1:2499 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7762
Practice Address - Country:US
Practice Address - Phone:512-897-8777
Practice Address - Fax:512-584-8106
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-13
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68813101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor