Provider Demographics
NPI:1104023936
Name:INGLE, SALLIE ELIZABETH (MA LPC)
Entity Type:Individual
Prefix:MS
First Name:SALLIE
Middle Name:ELIZABETH
Last Name:INGLE
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 1:1416 BRIARCLIFF BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1809
Mailing Address - Country:US
Mailing Address - Phone:512-576-1504
Mailing Address - Fax:512-374-9731
Practice Address - Street 1:1416 BRIARCLIFF BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1809
Practice Address - Country:US
Practice Address - Phone:512-576-1504
Practice Address - Fax:512-374-9731
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18592101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional