Provider Demographics
NPI:1376092924
Name:BRUSHY CREEK COUNSELING, PLLC
Entity Type:Organization
Organization Name:BRUSHY CREEK COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:512-947-5921
Mailing Address - Street 1:3207 BLUEBELL BEND CV
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-3808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1104 S MAYS ST
Practice Address - Street 2:106
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-6773
Practice Address - Country:US
Practice Address - Phone:512-947-5921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70826101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty