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General NPI Number Information
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NPI Number | 1922386499
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Entity Type | Organization
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Legal Business Name | AUSTIN COUNSELING & EVALUATION, LLP
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Dates
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Enumeration Date | 08/01/2011
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Last Update Date | 08/01/2011
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Provider Practice Location Address
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Address Line | 11675 JOLLYVILLE RD SUITE 111
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City | AUSTIN
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State | TX
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Zip | 78759-3939
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Country | US
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Telephone | 512-219-8828
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Fax | 512-219-8838
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Provider Business Mailing Address
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Address Line | 11675 JOLLYVILLE RD SUITE 111
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City | AUSTIN
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State | TX
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Zip | 78759-3939
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Country | US
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Telephone | 512-219-8828
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Fax | 512-219-8838
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Authorized Official
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Title or Position | PARTNER
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Name | DR. AUGUST DOLAN-HENDERSON
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Credential | PH.D.
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Telephone | 512-219-8828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 12630
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 12295
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 13219
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 32557
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License Number State | TX
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