Provider Demographics
NPI:1770803009
Name:HYATT, PAULA JAN (LPC)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:JAN
Last Name:HYATT
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 1:8500 N MOPAC EXPY
Mailing Address - Street 2:501
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8375
Mailing Address - Country:US
Mailing Address - Phone:512-567-9293
Mailing Address - Fax:512-691-9007
Practice Address - Street 1:8500 N MOPAC EXPY
Practice Address - Street 2:501
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8375
Practice Address - Country:US
Practice Address - Phone:512-567-9293
Practice Address - Fax:512-691-9007
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64266101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional