Provider Demographics
NPI:1841870201
Name:MATTINGLY, MARGARET (LPC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:MATTINGLY
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 1:825 W 11TH ST STE 1C
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-2052
Mailing Address - Country:US
Mailing Address - Phone:737-228-3760
Mailing Address - Fax:
Practice Address - Street 1:825 W 11TH ST STE 1C
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2052
Practice Address - Country:US
Practice Address - Phone:737-228-3760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-10
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82354101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health