Provider Demographics
NPI:1316239650
Name:JUSTO, NATASHA (LPC-S)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:JUSTO
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:M
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:403 GEYSER AVE
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-4019
Mailing Address - Country:US
Mailing Address - Phone:512-740-9365
Mailing Address - Fax:512-430-1370
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD STE 1
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8661
Practice Address - Country:US
Practice Address - Phone:512-815-5589
Practice Address - Fax:512-430-1370
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65619101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional