MEDICARE: AUSTIN CONCIERGE THERAPY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1386503159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUSTIN CONCIERGE THERAPY, INC.

Provider Business Mailing Address
First Line	:	12617 MONTEREY PATH
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78732-2445
Country	:	US
Telephone Number	:	512-940-5525
Fax Number	:

Provider Business Practice Location Address
First Line	:	6507 JESTER BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-8368
Country	:	US
Telephone Number	:	512-940-5525
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MARC GERONIMO
Credential	:	LMFT-A
Telephone Number	:	512-940-5525

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “AUSTIN CONCIERGE THERAPY, INC. ” Practice Location

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