Healthcare Provider Details

I. General information

NPI: 1497310817
Provider Name (Legal Business Name): AUSTIN COUNSELING AND HEALING CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 05/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 TAPADERA TRACE LN APT 1214
AUSTIN TX
78727-6320
US

IV. Provider business mailing address

5700 TAPADERA TRACE LN APT 1214
AUSTIN TX
78727-6320
US

V. Phone/Fax

Practice location:
  • Phone: 214-566-7202
  • Fax:
Mailing address:
  • Phone: 214-566-7202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MUKESH SHARMA
Title or Position: MANAGER
Credential:
Phone: 214-566-7202