Healthcare Provider Details

I. General information

NPI: 1962293100
Provider Name (Legal Business Name): AAYEH NICKY FALAHAT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 SHOAL CREEK BLVD BLDG 4
AUSTIN TX
78757-7591
US

IV. Provider business mailing address

10509 SPRINKLE CUTOFF RD
AUSTIN TX
78754-9608
US

V. Phone/Fax

Practice location:
  • Phone: 512-201-4501
  • Fax:
Mailing address:
  • Phone: 713-820-7577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number109270
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: