Provider Demographics
NPI:1710507504
Name:SUAREZ, DIANNA BELIA (MA, LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:BELIA
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:MA, LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8038 EXCHANGE DR APT 237
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-4807
Mailing Address - Country:US
Mailing Address - Phone:512-457-9881
Mailing Address - Fax:
Practice Address - Street 1:1102 W 6TH ST STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-5304
Practice Address - Country:US
Practice Address - Phone:512-730-1696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83252101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE