Provider Demographics
NPI:1255963203
Name:HAJARI, PRIYA (MED, LPC)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:HAJARI
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 1:3624 N HILLS DR STE A201
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3085
Mailing Address - Country:US
Mailing Address - Phone:737-204-8074
Mailing Address - Fax:
Practice Address - Street 1:8118 FRY RD STE 203
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7851
Practice Address - Country:US
Practice Address - Phone:281-377-3743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83190101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional