Healthcare Provider Details

I. General information

NPI: 1033303433
Provider Name (Legal Business Name): MARCI EDDINS WARREN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12335 HYMEADOW DR STE. 300
AUSTIN TX
78750-1934
US

IV. Provider business mailing address

12335 HYMEADOW DR STE. 300
AUSTIN TX
78750-1934
US

V. Phone/Fax

Practice location:
  • Phone: 512-663-8447
  • Fax: 512-250-0229
Mailing address:
  • Phone: 512-663-8447
  • Fax: 512-250-0229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number61980
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: