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General NPI Number Information
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NPI Number | 1245761923
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Entity Type | Organization
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Legal Business Name | CENTRAL AUSTIN PSYCHOTHERAPY
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Dates
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Enumeration Date | 03/23/2017
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 1704 W KOENIG LN
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City | AUSTIN
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State | TX
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Zip | 78756-1207
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Country | US
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Telephone | 512-588-2738
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Fax |
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Provider Business Mailing Address
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Address Line | 1704 W KOENIG LN
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City | AUSTIN
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State | TX
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Zip | 78756-1207
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Country | US
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Telephone | 512-588-2738
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Fax |
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Authorized Official
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Title or Position | OWNER/SUPERVISOR
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Name | TAMARA LINSEISEN
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Credential | ACSW, LCSW
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Telephone | 512-431-0014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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