Healthcare Provider Details

I. General information

NPI: 1902403470
Provider Name (Legal Business Name): DEIDRIE NAOMI ANDREA AUSTIN M.ED, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18806 ROBERTS RD
HOCKLEY TX
77447-9327
US

IV. Provider business mailing address

18806 ROBERTS RD
HOCKLEY TX
77447-9327
US

V. Phone/Fax

Practice location:
  • Phone: 281-351-4976
  • Fax:
Mailing address:
  • Phone: 713-265-7810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number84411
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number84411
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: