Provider Demographics
NPI:1386352680
Name:KLAZMER, SHIRA (LPC)
Entity type:Individual
Prefix:
First Name:SHIRA
Middle Name:
Last Name:KLAZMER
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 1:5838 BALCONES DR STE B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4206
Mailing Address - Country:US
Mailing Address - Phone:512-364-0167
Mailing Address - Fax:
Practice Address - Street 1:5838 BALCONES DR STE B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4206
Practice Address - Country:US
Practice Address - Phone:512-364-0167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83430101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health