Provider Demographics
NPI:1952884611
Name:AUSTIN, CLAIRA DIXIE-LEE (NCC)
Entity type:Individual
Prefix:MRS
First Name:CLAIRA
Middle Name:DIXIE-LEE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:CLAIRA
Other - Middle Name:DIXIE-LEE
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 TEPTAL TER
Mailing Address - Street 2:
Mailing Address - City:BRYSON CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28713-5479
Mailing Address - Country:US
Mailing Address - Phone:828-488-3294
Mailing Address - Fax:
Practice Address - Street 1:100 TEPTAL TER
Practice Address - Street 2:
Practice Address - City:BRYSON CITY
Practice Address - State:NC
Practice Address - Zip Code:28713-5479
Practice Address - Country:US
Practice Address - Phone:828-488-3294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14263101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional