Healthcare Provider Details

I. General information

NPI: 1548173636
Provider Name (Legal Business Name): REGENERATE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

8700 MENCHACA RD STE 306
AUSTIN TX
78748-5374
US

IV. Provider business mailing address

8700 MENCHACA RD STE 306
AUSTIN TX
78748-5374
US

V. Phone/Fax

Practice location:
  • Phone: 512-981-7046
  • Fax: 888-971-3727
Mailing address:
  • Phone: 512-981-7046
  • Fax: 888-971-3727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHANNON RUETER
Title or Position: OWNER/OPERATOR
Credential: LCSW
Phone: 512-981-7046