Provider Demographics
NPI:1982743142
Name:MUSICK, LAURIE SUZANNE (LPC)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:SUZANNE
Last Name:MUSICK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:S
Other - Last Name:BARTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:819 WATER ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5333
Mailing Address - Country:US
Mailing Address - Phone:830-792-3300
Mailing Address - Fax:830-792-5771
Practice Address - Street 1:180 W MILL ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5050
Practice Address - Country:US
Practice Address - Phone:830-620-6221
Practice Address - Fax:830-620-5302
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18322101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18322OtherLPC LICENSE
TX1678252-01Medicaid