Healthcare Provider Details

I. General information

NPI: 1093639684
Provider Name (Legal Business Name): CRICKETT BERLIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11701 FM 2244 RD STE 211
AUSTIN TX
78738-6468
US

IV. Provider business mailing address

11701 FM 2244 RD STE 211
AUSTIN TX
78738-6468
US

V. Phone/Fax

Practice location:
  • Phone: 512-360-0112
  • Fax:
Mailing address:
  • Phone: 512-360-0112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number93140
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: