Provider Demographics
NPI:1518267855
Name:TROUTNER, MAJORIE (LCDC)
Entity Type:Individual
Prefix:
First Name:MAJORIE
Middle Name:
Last Name:TROUTNER
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:MAJORIE
Other - Middle Name:LOUISE
Other - Last Name:TROUTNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCDC
Mailing Address - Street 1:1430 COLLIER ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-2911
Mailing Address - Country:US
Mailing Address - Phone:512-472-4357
Mailing Address - Fax:512-703-1394
Practice Address - Street 1:3000 OAK SPGS
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-2531
Practice Address - Country:US
Practice Address - Phone:512-804-3526
Practice Address - Fax:512-804-3590
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11138101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)