Provider Demographics
NPI:1881420784
Name:FLANNERY, TOBIE FUNTE (LPC-A, MA)
Entity type:Individual
Prefix:
First Name:TOBIE
Middle Name:FUNTE
Last Name:FLANNERY
Suffix:
Gender:F
Credentials:LPC-A, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 BARTON CREEK BLVD APT 3
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-1684
Mailing Address - Country:US
Mailing Address - Phone:512-923-1634
Mailing Address - Fax:
Practice Address - Street 1:2300 BARTON CREEK BLVD APT 3
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-1684
Practice Address - Country:US
Practice Address - Phone:512-923-1634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96016101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health