Provider Demographics
NPI:1689266272
Name:BACZEWSKI, ANIELA THERESE (MA, LPC)
Entity type:Individual
Prefix:
First Name:ANIELA
Middle Name:THERESE
Last Name:BACZEWSKI
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3653 CARINARO LOOP
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-2929
Mailing Address - Country:US
Mailing Address - Phone:512-623-0440
Mailing Address - Fax:
Practice Address - Street 1:1 CHISHOLM TRAIL RD STE 225
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5106
Practice Address - Country:US
Practice Address - Phone:512-956-6463
Practice Address - Fax:866-653-5142
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84885101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
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