Healthcare Provider Details

I. General information

NPI: 1215780044
Provider Name (Legal Business Name): MICHAEL J EBBINGHAUS II LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2024
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7035 BEE CAVES RD STE 104
AUSTIN TX
78746-5064
US

IV. Provider business mailing address

7035 BEE CAVES RD STE 104
AUSTIN TX
78746-5064
US

V. Phone/Fax

Practice location:
  • Phone: 512-710-4983
  • Fax:
Mailing address:
  • Phone: 512-965-8947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number89671
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: