Provider Demographics
NPI:1972883247
Name:HOWARD, DUSTIN (LPC)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:
Last Name:HOWARD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4122 TRAVIS ST UNIT 8
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-7548
Mailing Address - Country:US
Mailing Address - Phone:214-205-5004
Mailing Address - Fax:
Practice Address - Street 1:4122 TRAVIS ST UNIT 8
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-7548
Practice Address - Country:US
Practice Address - Phone:214-205-5004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60653467101YM0800X
TX65758101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health