Provider Demographics
NPI:1831799089
Name:TRABER, COURTNEY (MS, LPC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:TRABER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 W 3RD ST APT 404
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-4163
Mailing Address - Country:US
Mailing Address - Phone:405-919-7769
Mailing Address - Fax:
Practice Address - Street 1:6448 E HWY 290 STE E114
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1076
Practice Address - Country:US
Practice Address - Phone:512-561-0609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78432101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health