Provider Demographics
NPI:1386225027
Name:EBY, KEVIN II (LPC)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:EBY
Suffix:II
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 LOTT AVE
Mailing Address - Street 2:UNIT B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4425 SOUTH MOPAC EXPRESSWAY
Practice Address - Street 2:BUILDING 3 #503
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-7873
Practice Address - Country:US
Practice Address - Phone:512-240-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85545101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional