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NPI Code Detail

MEDICARE: KVT PSYCHOTHERAPY PLLC

MEDICARE: KVT PSYCHOTHERAPY PLLC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1205786399
Entity Type Code : Organization
Provider Name (Legal Business Name) : KVT PSYCHOTHERAPY PLLC
Provider Business Mailing Address
First Line : 5900 BALCONES DR STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78731-4298
Country : US
Telephone Number : 512-448-1208
Fax Number : 512-727-1070
Provider Business Practice Location Address
First Line : 5900 BALCONES DR STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78731-4298
Country : US
Telephone Number : 512-448-1208
Fax Number : 512-727-1070
Authorized Official
Title or Position : OWNER
Name : KATHLEEN VAN TIEM
Credential : LPC
Telephone Number : 512-448-1208
Provider Enumeration Date : 01/29/2026
Last Update Date : 01/29/2026

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