Provider Demographics
NPI:1346934635
Name:REYES, JANICE (MA, LMFT-A)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:MA, LMFT-A
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:KURCZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6003 SHANGHAI PIERCE RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-1929
Mailing Address - Country:US
Mailing Address - Phone:512-567-0396
Mailing Address - Fax:
Practice Address - Street 1:2520 LONGVIEW ST STE 307
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-4202
Practice Address - Country:US
Practice Address - Phone:512-607-9360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205070106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist