Provider Demographics
NPI:1578796066
Name:AVASTHI WARD, KIRAN (LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:KIRAN
Middle Name:
Last Name:AVASTHI WARD
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:KIRAN
Other - Middle Name:
Other - Last Name:AVASTHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-S
Mailing Address - Street 1:300 BEARDSLEY LN BLDG E
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-4954
Mailing Address - Country:US
Mailing Address - Phone:512-905-7543
Mailing Address - Fax:
Practice Address - Street 1:300 BEARDSLEY LN BLDG E
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-4954
Practice Address - Country:US
Practice Address - Phone:512-327-1759
Practice Address - Fax:512-327-3916
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19396101Y00000X, 101YS0200X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool