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General NPI Number Information
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NPI Number | 1780260471
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Entity Type | Organization
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Legal Business Name | OPEN HEART COUNSELING OF AUSTIN PLLC
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Dates
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Enumeration Date | 03/22/2021
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Last Update Date | 03/22/2021
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Provider Practice Location Address
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Address Line | 8101 W HIGHWAY 71
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City | AUSTIN
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State | TX
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Zip | 78735-8103
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Country | US
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Telephone | 254-718-8373
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Fax |
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Provider Business Mailing Address
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Address Line | 13587 MESA VERDE DR
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City | AUSTIN
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State | TX
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Zip | 78737-4714
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Country | US
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Telephone | 254-718-8373
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | LACEY FISHER
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Credential | LPC-S, RPT-S
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Telephone | 254-718-8373
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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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