Healthcare Provider Details

I. General information

NPI: 1912006073
Provider Name (Legal Business Name): ANN M DRAKE MA RN CS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 SPICEWOOD SPRINGS ROAD K-4
AUSTIN TX
78759
US

IV. Provider business mailing address

4131 SPICEWOOD SPRINGS ROAD BLD K SUITE 4 K-4
AUSTIN TX
78759
US

V. Phone/Fax

Practice location:
  • Phone: 512-345-7270
  • Fax: 512-345-1746
Mailing address:
  • Phone: 512-345-7270
  • Fax: 512-345-1746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number611024
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number004590042453LMFT
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number611024
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: