Provider Demographics
NPI:1841539426
Name:BUZEK, THERESA A (LPC-S)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:A
Last Name:BUZEK
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9364 BERNOULLI DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5040
Mailing Address - Country:US
Mailing Address - Phone:512-468-9959
Mailing Address - Fax:512-292-9388
Practice Address - Street 1:4009 BANISTER LN
Practice Address - Street 2:STE 356
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7040
Practice Address - Country:US
Practice Address - Phone:512-468-9959
Practice Address - Fax:512-292-9388
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-02
Last Update Date:2013-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional