Healthcare Provider Details

I. General information

NPI: 1790330363
Provider Name (Legal Business Name): ACURA JANAE BLAYLOCK MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2019
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 BALCONES DR # 22278
AUSTIN TX
78731-4257
US

IV. Provider business mailing address

5900 BALCONES DR # 22278
AUSTIN TX
78731-4257
US

V. Phone/Fax

Practice location:
  • Phone: 469-224-3241
  • Fax:
Mailing address:
  • Phone: 469-224-3241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number92314
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number92314
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number92314
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: