MEDICARE: ALISON LOUGH LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	73076	TX

General Provider Information

NPI Number	:	1952827636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON LOUGH LPC

Provider Business Mailing Address
First Line	:	14815 AVERY RANCH BLVD UNIT 1403
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78717-4034
Country	:	US
Telephone Number	:	832-264-8515
Fax Number	:

Provider Business Practice Location Address
First Line	:	13625 POND SPRINGS RD STE 104
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78729-4400
Country	:	US
Telephone Number	:	512-710-7354
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2017
Last Update Date	:	08/15/2017

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