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General NPI Number Information
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NPI Number | 1598639239
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Entity Type | Organization
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Legal Business Name | MARIPOSA INTEGRATIVE THERAPY
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Dates
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Enumeration Date | 10/04/2025
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Last Update Date | 10/04/2025
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Provider Practice Location Address
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Address Line | 13625 POND SPRINGS RD STE 105
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City | AUSTIN
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State | TX
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Zip | 78729-4400
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Country | US
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Telephone | 512-919-2069
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Fax |
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Provider Business Mailing Address
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Address Line | 1802 CLAY LN
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City | CEDAR PARK
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State | TX
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Zip | 78613-3539
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Country | US
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Telephone | 512-919-2069
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Fax | 512-919-2069
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Authorized Official
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Title or Position | PSYCHOTHERAPIST/OWNER
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Name | CAROLYN C MARTIN
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Credential | TEXAS LPC
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Telephone | 512-919-2069
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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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