Provider Demographics
NPI:1437596566
Name:MICHAEL J TELCH PHD & ASSOCIATES
Entity Type:Organization
Organization Name:MICHAEL J TELCH PHD & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TELCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-404-9118
Mailing Address - Street 1:2329 WESTLAKE DR
Mailing Address - Street 2:UNIT 4
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-2964
Mailing Address - Country:US
Mailing Address - Phone:512-560-4100
Mailing Address - Fax:512-590-8657
Practice Address - Street 1:2329 WESTLAKE DR
Practice Address - Street 2:UNIT 4
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-2964
Practice Address - Country:US
Practice Address - Phone:512-560-4100
Practice Address - Fax:512-590-8657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23316103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty