MEDICARE: NICKI MERCEDES AHUMADA LPC-ASSOCIATE

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	101YP2500X	Professional Counselor	96552	TX

General Provider Information

NPI Number	:	1528852738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICKI MERCEDES AHUMADA LPC-ASSOCIATE

Provider Business Mailing Address
First Line	:	9000 EDMUNDSBURY DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78747-3999
Country	:	US
Telephone Number	:	620-339-1231
Fax Number	:

Provider Business Practice Location Address
First Line	:	1714 FORTVIEW RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-7671
Country	:	US
Telephone Number	:	620-339-1231
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2025
Last Update Date	:	04/04/2025

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