Provider Demographics
NPI:1598314924
Name:WACHSMAN, DAVID (LPC-INTERN)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:WACHSMAN
Suffix:
Gender:M
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 W SLAUGHTER LN APT 2401
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6755
Mailing Address - Country:US
Mailing Address - Phone:512-800-1118
Mailing Address - Fax:
Practice Address - Street 1:5920 W WILLIAM CANNON DR STE 150
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1902
Practice Address - Country:US
Practice Address - Phone:512-800-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82151101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health