Provider Demographics
NPI:1902403470
Name:AUSTIN, DEIDRIE NAOMI ANDREA (MED, LPC)
Entity Type:Individual
Prefix:
First Name:DEIDRIE NAOMI
Middle Name:ANDREA
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18806 ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447-9327
Mailing Address - Country:US
Mailing Address - Phone:713-265-7810
Mailing Address - Fax:
Practice Address - Street 1:18806 ROBERTS RD
Practice Address - Street 2:
Practice Address - City:HOCKLEY
Practice Address - State:TX
Practice Address - Zip Code:77447-9327
Practice Address - Country:US
Practice Address - Phone:281-351-4976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84411101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor