Healthcare Provider Details
I. General information
NPI: 1902746043
Provider Name (Legal Business Name): AXOLOTL MENTAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
431 MIDDLE CRK
BUDA TX
78610-2765
US
IV. Provider business mailing address
431 MIDDLE CRK
BUDA TX
78610-2765
US
V. Phone/Fax
- Phone: 214-738-8712
- Fax:
- Phone: 214-738-8712
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TIFFANY
POINSETT
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 214-738-8712