Provider Demographics
NPI:1861552697
Name:PASCOE, DIANE L (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:L
Last Name:PASCOE
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CYPRESS CREEK RD STE 403
Mailing Address - Street 2:CEDAR PARK
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4470
Mailing Address - Country:US
Mailing Address - Phone:512-289-4664
Mailing Address - Fax:
Practice Address - Street 1:1001 CYPRESS CREEK RD STE 403
Practice Address - Street 2:CEDAR PARK
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4470
Practice Address - Country:US
Practice Address - Phone:512-289-4664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1867106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX028486101Medicaid
TX2756LCOtherBLUE CROSS/BLUE SHIELD