MEDICARE: BENJAMIN J WARNER PHD, LPC, LPC-S

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	20176	TX
2	101YM0800X	Mental Health Counselor	20176	TX

General Provider Information

NPI Number	:	1386851301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN J WARNER PHD, LPC, LPC-S

Provider Business Mailing Address
First Line	:	1515 S CAPITAL OF TEXAS HWY STE 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-6544
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 S CAPITAL OF TEXAS HWY STE 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-6544
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	06/03/2024

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