MEDICARE: SPECTRUM SOCIAL AND RECREATION SERVICES, LLC

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	252Y00000X	Early Intervention Provider Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1770877342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECTRUM SOCIAL AND RECREATION SERVICES, LLC

Provider Business Mailing Address
First Line	:	1509 W NORTH LOOP BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-2004
Country	:	US
Telephone Number	:	512-524-5482
Fax Number	:	512-524-1177

Provider Business Practice Location Address
First Line	:	1509 W NORTH LOOP BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-2004
Country	:	US
Telephone Number	:	512-524-5482
Fax Number	:	512-524-1177

Authorized Official
Title or Position	:	PARTNER / BUSINESS MANAGER
Name	:	MRS. SHANNA KEMP
Credential	:	M.ED.
Telephone Number	:	512-524-5482

Provider Enumeration Date	:	06/01/2011
Last Update Date	:	06/01/2011

Similar Medicare Providers

1003197351 — JOLE LEHR-FIZER BCBA, CTRS
Practice Location Address:

1509 W NORTH LOOP BLVD
AUSTIN, TX
78756-2004

Practice Phone: 512-524-5482
Practice Fax: 512-524-1177

1710245253 — SIMONA RIEMER LMSW
Practice Location Address:

1509 W NORTH LOOP BLVD
AUSTIN, TX
78756-2004

Practice Phone: 512-524-5482
Practice Fax: 512-524-1177

1841558384 — LISA LASATER PH.D.
Practice Location Address:

1509 W NORTH LOOP BLVD
AUSTIN, TX
78756-2004

Practice Phone: 512-524-5482
Practice Fax: 512-524-1177

1235663394 — LESLIE GUERRERO
Practice Location Address:

1505 W NORTH LOOP BLVD
AUSTIN, TX
78756-2004

Practice Phone: 512-709-8234
Practice Fax:

1497912109 — CLARITYMD, LLC
Practice Location Address:

3104 LATING STREAM LN
AUSTIN, TX
78746-2004

Practice Phone: 512-826-1245
Practice Fax:

1316257991 — SCOTTIE HALE BUEHLER CPM, LM
Practice Location Address:

2004 ROSEWOOD AVE
AUSTIN, TX
78702

Practice Phone: 512-658-8301
Practice Fax:

Directions to “SPECTRUM SOCIAL AND RECREATION SERVICES, LLC ” 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 © 2007-2026 (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.