Provider Demographics
NPI:1487675419
Name:BIRNEY, NADINE H (LPC)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:H
Last Name:BIRNEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9501 UTICA DR
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-4825
Mailing Address - Country:US
Mailing Address - Phone:806-798-2870
Mailing Address - Fax:
Practice Address - Street 1:8212 ITHACA AVE
Practice Address - Street 2:SUITE E 6 D
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2632
Practice Address - Country:US
Practice Address - Phone:806-535-4447
Practice Address - Fax:806-792-3690
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14482101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0276214-01Medicaid