Provider Demographics
NPI:1205943685
Name:BIRCHILL LAVERGNE, AMY FRANCES (MED, LMFT-S, LPC-S)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:FRANCES
Last Name:BIRCHILL LAVERGNE
Suffix:
Gender:F
Credentials:MED, LMFT-S, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2142 BELVEDERE CT
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2687
Mailing Address - Country:US
Mailing Address - Phone:713-502-8028
Mailing Address - Fax:
Practice Address - Street 1:542 COMAL AVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-7629
Practice Address - Country:US
Practice Address - Phone:713-502-8028
Practice Address - Fax:210-855-0507
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64545101YM0800X
CAMFC 42975106H00000X
TX201270106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health