Provider Demographics
NPI:1346706710
Name:KAVENEY, ALICIA (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:KAVENEY
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:MUNGUIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1430 COLLIER ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-2911
Mailing Address - Country:US
Mailing Address - Phone:512-472-4357
Mailing Address - Fax:512-703-1394
Practice Address - Street 1:2501 W WILLIAM CANNON DR BLDG 4
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5281
Practice Address - Country:US
Practice Address - Phone:512-804-3687
Practice Address - Fax:512-476-0217
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14766101YA0400X
TX76453101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)