Provider Demographics
NPI:1720677792
Name:MATIJEVICH, BARBARA JEANNE (LPC-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEANNE
Last Name:MATIJEVICH
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4422 PACK SADDLE PASS STE 103
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1644
Mailing Address - Country:US
Mailing Address - Phone:512-975-2161
Mailing Address - Fax:
Practice Address - Street 1:4422 PACK SADDLE PASS STE 103
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1644
Practice Address - Country:US
Practice Address - Phone:512-975-2161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82873101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health