Healthcare Provider Details

I. General information

NPI: 1699475509
Provider Name (Legal Business Name): ACTION BEHAVIOR CENTERS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 BEE CAVES RD BLDG 2-100
AUSTIN TX
78746-5842
US

IV. Provider business mailing address

6300 BEE CAVES RD BLDG 2-100
AUSTIN TX
78746-5842
US

V. Phone/Fax

Practice location:
  • Phone: 512-508-3941
  • Fax:
Mailing address:
  • Phone: 512-508-3941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA LOPEZ
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 512-508-3941