Provider Demographics
NPI:1306916051
Name:MCGUIRE, JOAN LESLIE (LPC)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:LESLIE
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 W 31ST ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-2099
Mailing Address - Country:US
Mailing Address - Phone:512-698-6468
Mailing Address - Fax:
Practice Address - Street 1:1011 W 31ST ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2099
Practice Address - Country:US
Practice Address - Phone:512-698-6468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17656101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional