MEDICARE: ABBY AUSTIN

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	CTB-2025-0930	NM

General Provider Information

NPI Number	:	1790641546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBY AUSTIN

Provider Business Mailing Address
First Line	:	677 FAUST RD UNIT 11
Second Line	:
City	:	BURLINGTON
State	:	WI
Zip	:	53105-5628
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2209 MIGUEL CHAVEZ RD
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-6914
Country	:	US
Telephone Number	:	505-388-2361
Fax Number	:

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

Provider Enumeration Date	:	12/24/2025
Last Update Date	:	12/24/2025

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Directions to “ ABBY AUSTIN ” Practice Location

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