MEDICARE: LINDSAY ANNE TUBBS MA, LPC

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	72655	TX
2	101YP2500X	Professional Counselor	72655	TX

General Provider Information

NPI Number	:	1548705304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY ANNE TUBBS MA, LPC

Provider Business Mailing Address
First Line	:	4920 N IH 35
Second Line	:	STE 110
City	:	AUSTIN
State	:	TX
Zip	:	78751-2716
Country	:	US
Telephone Number	:	512-854-1903
Fax Number	:

Provider Business Practice Location Address
First Line	:	4920 N IH 35
Second Line	:	STE 110
City	:	AUSTIN
State	:	TX
Zip	:	78751-2716
Country	:	US
Telephone Number	:	512-854-1903
Fax Number	:

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

Provider Enumeration Date	:	01/03/2017
Last Update Date	:	01/10/2017

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