Basic Information
Provider Information
NPI: 1760126387
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAJULA
FirstName: ERIK
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MA, LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1430 COLLIER ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787042911
CountryCode: US
TelephoneNumber: 5124724357
FaxNumber: 5127031394
Practice Location
Address1: 1717 W 10TH ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787033907
CountryCode: US
TelephoneNumber: 5128043000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/21/2022
LastUpdateDate: 04/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X88558TXY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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