MEDICARE: WELLNESS WITH DR AUSTIN COUNSELING GROUP

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851942890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNESS WITH DR AUSTIN COUNSELING GROUP

Provider Business Mailing Address
First Line	:	1806 SAXON BEND TRL
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-4762
Country	:	US
Telephone Number	:	713-359-6423
Fax Number	:	346-843-2947

Provider Business Practice Location Address
First Line	:	4800 SUGAR GROVE BLVD STE 607
Second Line	:
City	:	STAFFORD
State	:	TX
Zip	:	77477-2150
Country	:	US
Telephone Number	:	713-359-6423
Fax Number	:	346-843-2947

Authorized Official
Title or Position	:	OWNER AND OPERATOR
Name	:	DR. MAKALA M AUSTIN
Credential	:	LCSW, PHD
Telephone Number	:	713-359-6423

Provider Enumeration Date	:	09/20/2019
Last Update Date	:	09/20/2019

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