Provider Demographics
NPI:1194048603
Name:KOUDELKA, JILL M (LPC, LMFT)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:M
Last Name:KOUDELKA
Suffix:
Gender:
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:SWINNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5750 BALCONES DR STE 117C
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4252
Mailing Address - Country:US
Mailing Address - Phone:281-408-3183
Mailing Address - Fax:
Practice Address - Street 1:5750 BALCONES DR STE 117C
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4252
Practice Address - Country:US
Practice Address - Phone:281-408-3183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201221106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist