Healthcare Provider Details
I. General information
NPI: 1093828485
Provider Name (Legal Business Name): CREEKSIDE MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3215 STECK AVE SUITE 100
AUSTIN TX
78757-7566
US
IV. Provider business mailing address
3215 STECK AVE SUITE 100
AUSTIN TX
78757-7566
US
V. Phone/Fax
- Phone: 512-452-2929
- Fax:
- Phone: 512-452-2929
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 41218 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
STREUSAND
Title or Position: PRESIDENT
Credential: M.D.
Phone: 512-452-2929