Provider Demographics
NPI:1497383848
Name:OVERBECK, NICHOLAS (LPC)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:OVERBECK
Suffix:
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 1:2535 E SOUTHLAKE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6629
Mailing Address - Country:US
Mailing Address - Phone:214-914-2887
Mailing Address - Fax:
Practice Address - Street 1:2535 E SOUTHLAKE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6629
Practice Address - Country:US
Practice Address - Phone:214-914-2887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78147101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health