Healthcare Provider Details

I. General information

NPI: 1902574924
Provider Name (Legal Business Name): AUSTIN BAILEY BYRNE RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AUSTIN B BYRNE

II. Dates (important events)

Enumeration Date: 09/03/2021
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 PATHFINDER WAY
ROCKLEDGE FL
32955-3216
US

IV. Provider business mailing address

3500 DEPAUW BLVD STE 3070
INDIANAPOLIS IN
46268-6135
US

V. Phone/Fax

Practice location:
  • Phone: 321-655-5880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-451967
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: