Provider Demographics
NPI:1104800739
Name:DOSTAL, ALAN J (LPC)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:J
Last Name:DOSTAL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:ALAN
Other - Middle Name:J
Other - Last Name:DOSTAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:2616 S CLACK ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-1557
Mailing Address - Country:US
Mailing Address - Phone:325-690-5131
Mailing Address - Fax:325-690-5228
Practice Address - Street 1:2616 S CLACK ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-1557
Practice Address - Country:US
Practice Address - Phone:325-690-5131
Practice Address - Fax:325-690-5228
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16390101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional