Provider Demographics
NPI:1518791383
Name:BORELLIS, DAWN MARIE (LPC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:BORELLIS
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 1:407 BROOKS HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-3479
Mailing Address - Country:US
Mailing Address - Phone:512-773-1219
Mailing Address - Fax:
Practice Address - Street 1:14425 FALCON HEAD BLVD
Practice Address - Street 2:
Practice Address - City:BEE CAVE
Practice Address - State:TX
Practice Address - Zip Code:78738-4412
Practice Address - Country:US
Practice Address - Phone:512-957-0177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89703101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health