MEDICARE: AUSTIN TYLER NICHOLS LPC

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	93026	TX

General Provider Information

NPI Number	:	1952262446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN TYLER NICHOLS LPC

Provider Business Mailing Address
First Line	:	PO BOX 1369
Second Line	:
City	:	SEGUIN
State	:	TX
Zip	:	78156-1369
Country	:	US
Telephone Number	:	512-738-7925
Fax Number	:

Provider Business Practice Location Address
First Line	:	11701 FM 2244 RD STE 211
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78738-6468
Country	:	US
Telephone Number	:	512-738-7925
Fax Number	:

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

Provider Enumeration Date	:	11/24/2025
Last Update Date	:	11/24/2025

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