Healthcare Provider Details

I. General information

NPI: 1316101132
Provider Name (Legal Business Name): JOHN KAUFFROTH LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 DUVAL RD BUILDING 3
AUSTIN TX
78759-3550
US

IV. Provider business mailing address

4100 DUVAL RD BLDG 3
AUSTIN TX
78759-4275
US

V. Phone/Fax

Practice location:
  • Phone: 512-485-7200
  • Fax: 512-485-7220
Mailing address:
  • Phone: 512-485-7200
  • Fax: 512-485-7220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10742
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: