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NPI Code Detail

MEDICARE: AUSTIN TRAVIS COUNTY MENTAL HEALTH AND MENTAL RETARDATION CENTER

MEDICARE: AUSTIN TRAVIS COUNTY MENTAL HEALTH AND MENTAL RETARDATION CENTER
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
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor
3103TC0700XClinical Psychologist
4103TC2200XClinical Child & Adolescent Psychologist
5104100000XSocial Worker
61041C0700XClinical Social Worker
7106H00000XMarriage & Family Therapist
8171M00000XCase Manager/Care Coordinator
92084P0804XChild & Adolescent Psychiatry Physician
10261Q00000XClinic/Center
11261QD1600XDevelopmental Disabilities Clinic/Center
12261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
13363A00000XPhysician Assistant
14363LP0808XPsychiatric/Mental Health Nurse Practitioner
152084P0800XPsychiatry Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1017413801OTHERTXECI CM
21335424-01OTHERTXMR SC
31335242-02OTHERTXMH CM
400P336OTHERTXBLUE CROSS BLUE SHIELD TX
51335424-04OTHERTXMH REHAB
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750337259
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUSTIN TRAVIS COUNTY MENTAL HEALTH AND MENTAL RETARDATION CENTER
Provider Business Mailing Address
First Line : 1430 COLLIER ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-2911
Country : US
Telephone Number : 512-447-4141
Fax Number : 512-440-4080
Provider Business Practice Location Address
First Line : 1430 COLLIER ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-2911
Country : US
Telephone Number : 512-472-4357
Fax Number : 512-703-1394
Authorized Official
Title or Position : CHIEF MEDICAL OFFICER
Name : DR. ZIYAD B. NUWAYHID
Credential : MD
Telephone Number : 512-447-4141
Provider Enumeration Date : 05/26/2006
Last Update Date : 11/09/2022

Similar Medicare Providers

1346192234 — JEREMY WEINTRAUB
Practice Location Address:
1430 COLLIER ST
AUSTIN, TX
78704-2911
Practice Phone: 914-806-4456
Practice Fax:
1043316508 — DR. JAMES RUSSEL VAN NORMAN MD
Practice Location Address:
1430 COLLIER ST
AUSTIN, TX
78704-2911
Practice Phone: 512-472-4357
Practice Fax: 512-703-1394
1710048665 — DR. DAVID DURAN PH.D.
Practice Location Address:
1430 COLLIER ST
AUSTIN, TX
78704-2911
Practice Phone: 512-445-7787
Practice Fax: 512-440-4059
1003970476 — CHRISTEN KAVANAUGH SCHULTE RN
Practice Location Address:
1430 COLLIER ST
AUSTIN, TX
78704-2911
Practice Phone: 512-445-7787
Practice Fax: 512-440-4059
1861548745 — MR. ABRAHAM MINJARES LPC
Practice Location Address:
1430 COLLIER ST
AUSTIN, TX
78704-2911
Practice Phone: 512-445-7783
Practice Fax: 512-440-4081
1255451068 — MS. STACY LINETTE SPENCER LCSW
Practice Location Address:
1430 COLLIER ST
AUSTIN, TX
78704-2911
Practice Phone: 512-445-7787
Practice Fax: 512-440-4059

Directions to “AUSTIN TRAVIS COUNTY MENTAL HEALTH AND MENTAL RETARDATION CENTER ” Practice Location

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