Provider Demographics
NPI:1356408959
Name:STRARUP, TINA RENEE (LPC)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:RENEE
Last Name:STRARUP
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 1:6915 LANGSTON DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2219
Mailing Address - Country:US
Mailing Address - Phone:512-625-5660
Mailing Address - Fax:512-926-5072
Practice Address - Street 1:1518 W KOENIG LN
Practice Address - Street 2:STE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-1416
Practice Address - Country:US
Practice Address - Phone:512-625-5660
Practice Address - Fax:512-926-5072
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC 16715101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional