Provider Demographics
NPI:1992211460
Name:AUSTIN THERAPY FOR GIRLS
Entity Type:Organization
Organization Name:AUSTIN THERAPY FOR GIRLS
Other - Org Name:HOUSTON THERAPY FOR GIRLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKSDALE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-626-6955
Mailing Address - Street 1:1806 BROOKHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2525 WALLINGWOOD DR STE 800
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6930
Practice Address - Country:US
Practice Address - Phone:512-626-6955
Practice Address - Fax:512-626-6955
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUSTIN THERAPY FOR GIRLS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health