Healthcare Provider Details

I. General information

NPI: 1366323875
Provider Name (Legal Business Name): ELVIRA ALEJANDRA MARIN LPC-ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 W ANDERSON LANE STE C 200 PMB 1119
AUSTIN TX
78757
US

IV. Provider business mailing address

2900 W ANDERSON LANE STE C 200 PMB 1119
AUSTIN TX
78757-1102
US

V. Phone/Fax

Practice location:
  • Phone: 512-394-4561
  • Fax:
Mailing address:
  • Phone: 512-394-4561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number99296
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: