Healthcare Provider Details

I. General information

NPI: 1548940596
Provider Name (Legal Business Name): BIRDSONG PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 MELLER GDNS
AUSTIN TX
78741-3920
US

IV. Provider business mailing address

5900 BALCONES DR STE 100
AUSTIN TX
78731-4298
US

V. Phone/Fax

Practice location:
  • Phone: 832-643-5877
  • Fax:
Mailing address:
  • Phone: 512-601-0450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MISS CELESTIE BAO-HAN NGUYEN
Title or Position: OWNER
Credential: LCSW
Phone: 512-601-0450