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General NPI Number Information
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NPI Number | 1447107693
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Entity Type | Organization
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Legal Business Name | GOLDEN MEAN INTEGRATIVE THERAPY, PLLC
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 808 ALLENDE BND
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City | AUSTIN
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State | TX
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Zip | 78748-1438
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Country | US
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Telephone | 737-781-0488
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Fax |
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Provider Business Mailing Address
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Address Line | 500 PUERTA VALLARTA LN
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City | AUSTIN
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State | TX
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Zip | 78748-4067
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | SHAWN CLARK-MARTINEZ
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Credential |
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Telephone | 737-781-0488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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