Provider Demographics
NPI:1598502619
Name:AGUREN, ALEXIS PAIGE (LCSW)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:PAIGE
Last Name:AGUREN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4504 MERLE DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1730
Mailing Address - Country:US
Mailing Address - Phone:832-588-5717
Mailing Address - Fax:
Practice Address - Street 1:303 CAMP CRAFT RD STE 300
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6509
Practice Address - Country:US
Practice Address - Phone:512-200-4069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1047801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical