Provider Demographics
NPI:1619491065
Name:MINNIX, GENA MARIE (LPC-S, LMFT-S)
Entity Type:Individual
Prefix:DR
First Name:GENA
Middle Name:MARIE
Last Name:MINNIX
Suffix:
Gender:F
Credentials:LPC-S, LMFT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-3126
Mailing Address - Country:US
Mailing Address - Phone:512-520-7820
Mailing Address - Fax:
Practice Address - Street 1:3311 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-3126
Practice Address - Country:US
Practice Address - Phone:512-520-7820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201671106H00000X
TX67015101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist