Provider Demographics
NPI:1548279839
Name:MENDL, BETTY LYNN (MA, LPC)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:LYNN
Last Name:MENDL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5511 PARKCREST DR STE 205
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4937
Mailing Address - Country:US
Mailing Address - Phone:512-423-5028
Mailing Address - Fax:
Practice Address - Street 1:5511 PARKCREST DR STE 205
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4937
Practice Address - Country:US
Practice Address - Phone:512-423-5028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16404101YP1600X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional