Provider Demographics
NPI:1861816233
Name:WASKOVIAK STEARNS, CARMELA ANNE (NCC, LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:CARMELA
Middle Name:ANNE
Last Name:WASKOVIAK STEARNS
Suffix:
Gender:F
Credentials:NCC, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 CANYON OAK LOOP
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-2048
Mailing Address - Country:US
Mailing Address - Phone:512-635-7085
Mailing Address - Fax:
Practice Address - Street 1:102 W MORROW ST
Practice Address - Street 2:SUITE 202
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-4307
Practice Address - Country:US
Practice Address - Phone:512-931-4008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58531101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional