Provider Demographics
NPI:1841737970
Name:CORCORAN, ARIANE ALEXIS REIS (LMFTA)
Entity Type:Individual
Prefix:
First Name:ARIANE
Middle Name:ALEXIS REIS
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1202
Mailing Address - Country:US
Mailing Address - Phone:512-814-6294
Mailing Address - Fax:512-710-0558
Practice Address - Street 1:507 W 17TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1202
Practice Address - Country:US
Practice Address - Phone:512-814-6294
Practice Address - Fax:512-710-0558
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202651106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist