MEDICARE: INNER CITY COMMUNITY SERVICES, INC.

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	101YP2500X	Professional Counselor	63484	TX

General Provider Information

NPI Number	:	1295053304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER CITY COMMUNITY SERVICES, INC.

Provider Business Mailing Address
First Line	:	5811 BERKMAN DR
Second Line	:	SUITE 132
City	:	AUSTIN
State	:	TX
Zip	:	78723-2666
Country	:	US
Telephone Number	:	512-809-1695
Fax Number	:	206-337-7327

Provider Business Practice Location Address
First Line	:	5811 BERKMAN DR
Second Line	:	SUITE 132
City	:	AUSTIN
State	:	TX
Zip	:	78723-2666
Country	:	US
Telephone Number	:	512-809-1695
Fax Number	:	206-337-7327

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MITCHELL EDWARDS
Credential	:
Telephone Number	:	512-809-1695

Provider Enumeration Date	:	05/13/2010
Last Update Date	:	05/13/2010

Similar Medicare Providers

1740438662 — MR. MARCUS JONES
Practice Location Address:

5811 BERKMAN DR , 121
AUSTIN, TX
78723-2666

Practice Phone: 512-926-2400
Practice Fax: 512-926-2608

1891092532 — BRADLEY SAUCEDA
Practice Location Address:

5811 BERKMAN DR , SUITE 121
AUSTIN, TX
78723-2666

Practice Phone: 512-825-5060
Practice Fax:

1235559626 — SILVIA GONZALEZ OTL
Practice Location Address:

10012 MOUNT RAINIER DR
AUSTIN, TX
78747-2666

Practice Phone: 512-372-3777
Practice Fax:

1427546381 — PATRICK ALLAN EUBANKS
Practice Location Address:

3401 S LAMAR BLVD APT 3346
AUSTIN, TX
78704-2666

Practice Phone: 737-346-8734
Practice Fax:

1083577852 — ALLISON CUNNING
Practice Location Address:

4900 MUELLER BLVD
AUSTIN, TX
78723-3051

Practice Phone: 512-324-0000
Practice Fax:

1801750203 — SPENCER WESTCOTT
Practice Location Address:

4900 MUELLER BLVD
AUSTIN, TX
78723-3051

Practice Phone: 732-682-2495
Practice Fax:

Directions to “INNER CITY COMMUNITY SERVICES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.