Provider Demographics
NPI:1013922103
Name:FOUSEK, RHONDA K (LPC)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:K
Last Name:FOUSEK
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:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:VANDERPOOL
Mailing Address - State:TX
Mailing Address - Zip Code:78885-0236
Mailing Address - Country:US
Mailing Address - Phone:830-796-5533
Mailing Address - Fax:830-966-5198
Practice Address - Street 1:1856 EVANS CREEK RD
Practice Address - Street 2:
Practice Address - City:VANDERPOOL
Practice Address - State:TX
Practice Address - Zip Code:78885-0236
Practice Address - Country:US
Practice Address - Phone:830-796-5533
Practice Address - Fax:830-966-5198
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16861101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141877403Medicaid
TX125202OtherCHIP
TX7636153OtherAETNA
TX83708LOtherBLUE CROSS/BLUE SHIELD