Provider Demographics
NPI:1861056996
Name:MANGANELLA, KATY (MA, LPC)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:
Last Name:MANGANELLA
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 1:5524 BEE CAVES RD
Mailing Address - Street 2:BUILDING E, SUITE 2
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-883-9224
Mailing Address - Fax:
Practice Address - Street 1:5524 BEE CAVES RD
Practice Address - Street 2:BUILDING E, SUITE 2
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-883-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80074101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health