MEDICARE: DR. AMANDA MIXON LPC-ASSOCIATE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	99116	TX

General Provider Information

NPI Number	:	1154209195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA MIXON LPC-ASSOCIATE

Provider Business Mailing Address
First Line	:	7506 SAINT AMANT PL APT A
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-2598
Country	:	US
Telephone Number	:	903-987-3405
Fax Number	:

Provider Business Practice Location Address
First Line	:	7506 SAINT AMANT PL APT A
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-2598
Country	:	US
Telephone Number	:	903-987-3405
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2025
Last Update Date	:	08/26/2025

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