Provider Demographics
NPI:1053772624
Name:DZIOLEK, DINAH (LPC-S)
Entity type:Individual
Prefix:
First Name:DINAH
Middle Name:
Last Name:DZIOLEK
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 MYSTIC PKWY
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-5285
Mailing Address - Country:US
Mailing Address - Phone:888-623-8890
Mailing Address - Fax:844-654-0224
Practice Address - Street 1:623 STATE HIGHWAY 46 E
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-5757
Practice Address - Country:US
Practice Address - Phone:888-623-8890
Practice Address - Fax:844-654-0224
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0179831101YM0800X
MO2021049363101YP2500X
AZLPC-20797101YP2500X
TX80062101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health