MEDICARE: POSEY PSYCHOLOGY 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
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1720681778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSEY PSYCHOLOGY PLLC

Provider Business Mailing Address
First Line	:	1602 BAY HILL DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-6248
Country	:	US
Telephone Number	:	512-914-9565
Fax Number	:

Provider Business Practice Location Address
First Line	:	4601 SPICEWOOD SPRINGS RD STE 200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8598
Country	:	US
Telephone Number	:	512-467-1376
Fax Number	:	512-467-8658

Authorized Official
Title or Position	:	AGENT/MANAGER
Name	:	DR. SUSIE KAISER POSEY
Credential	:	PSYD
Telephone Number	:	512-467-1376

Provider Enumeration Date	:	11/20/2020
Last Update Date	:	11/20/2020

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Directions to “POSEY PSYCHOLOGY PLLC ” Practice Location

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