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General NPI Number Information
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NPI Number | 1215780044
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Entity Type | Individual
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Provider Name | MICHAEL J EBBINGHAUS II LPC
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Gender | Male
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Dates
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Enumeration Date | 04/10/2024
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 11719 BEE CAVES RD STE 200
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City | BEE CAVE
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State | TX
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Zip | 78738-5540
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Country | US
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Telephone | 737-301-9014
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Fax |
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Provider Business Mailing Address
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Address Line | 412 E WILLIAM CANNON DR APT 1908
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City | AUSTIN
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State | TX
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Zip | 78745-5781
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Country | US
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Telephone | 512-965-8947
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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