Provider Demographics
NPI:1598986424
Name:AUSTIN, DIANA LYNN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:LYNN
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:DIANA
Other - Middle Name:LYNN
Other - Last Name:MICHAELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:605 HORIZON PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-2006
Mailing Address - Country:US
Mailing Address - Phone:512-296-0863
Mailing Address - Fax:512-548-7659
Practice Address - Street 1:605 HORIZON PARK BLVD
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-2006
Practice Address - Country:US
Practice Address - Phone:512-296-0863
Practice Address - Fax:512-548-7659
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62759101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203380503Medicaid