Provider Demographics
NPI:1235798018
Name:CREARY, ASHA MONIQUE (LPC)
Entity Type:Individual
Prefix:
First Name:ASHA
Middle Name:MONIQUE
Last Name:CREARY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHISHOLM TRAIL RD STE 450
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5094
Mailing Address - Country:US
Mailing Address - Phone:972-375-2597
Mailing Address - Fax:512-546-6797
Practice Address - Street 1:1311 CHISHOLM TRAIL RD STE 201
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-2969
Practice Address - Country:US
Practice Address - Phone:512-546-6798
Practice Address - Fax:512-591-0049
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional