Provider Demographics
NPI:1881092807
Name:DAVID, KATY (MA, LPC)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:
Last Name:DAVID
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:DAVID
Other - Last Name:MGUFFEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:1600 MAPLE AVE # 1
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-1405
Mailing Address - Country:US
Mailing Address - Phone:512-660-9611
Mailing Address - Fax:512-684-0527
Practice Address - Street 1:1210 ROSEWOOD AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-2023
Practice Address - Country:US
Practice Address - Phone:512-660-9611
Practice Address - Fax:305-832-0971
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69652101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional