Provider Demographics
NPI:1265716112
Name:PAUL, DEEANN L (LPC)
Entity type:Individual
Prefix:
First Name:DEEANN
Middle Name:L
Last Name:PAUL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 SHADOW OAK LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1266
Mailing Address - Country:US
Mailing Address - Phone:512-328-3146
Mailing Address - Fax:512-328-3146
Practice Address - Street 1:2501 W WILLIAM CANNON DR
Practice Address - Street 2:BLDG 6, SUITE A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5281
Practice Address - Country:US
Practice Address - Phone:512-344-9181
Practice Address - Fax:512-344-9135
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63834101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional