Provider Demographics
NPI:1790367670
Name:BAUERKEMPER, DAVID ANDREW (MS, LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ANDREW
Last Name:BAUERKEMPER
Suffix:
Gender:M
Credentials:MS, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 LAKE SIDE LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-7466
Mailing Address - Country:US
Mailing Address - Phone:512-627-3145
Mailing Address - Fax:
Practice Address - Street 1:6600 PAIGE RD STE 215
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-4501
Practice Address - Country:US
Practice Address - Phone:469-269-2826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12276101YA0400X
TX75398101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1336797430OtherINSURANCE PROVIDERS