Healthcare Provider Details

I. General information

NPI: 1205628286
Provider Name (Legal Business Name): THERAPY AUSTIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 W SLAUGHTER LN
AUSTIN TX
78748-6900
US

IV. Provider business mailing address

10290 ALLIANCE RD
BLUE ASH OH
45242-4710
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AMY BERLIN
Title or Position: THERAPIST
Credential: LMSW
Phone: 512-201-4501