Organization Active NPI

Elliott and Grace LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Austin, TX
National Provider Identifier
1003643768
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ELLIOTT AND GRACE LLC
Practice address
5900 Balcones Dr Ste 100
Austin, TX 78731-4298
Phone
(512) 318-2199
NPI assigned
Sep 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Precious Jimbola ChandlerNPI 1912687310
Title
Member
Phone
(210) 809-4289

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

5900 Balcones Dr Ste 100
Austin, TX 78731-4298

Mailing address

5900 Balcones Dr Ste 100
Austin, TX 78731-4298

Other names 1

  • Selah Psychiatry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1003643768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "512-318-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOTT AND GRACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "CHANDLER",
        "authorized_official_first_name": "PRECIOUS",
        "authorized_official_middle_name": "JIMBOLA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "210-809-4289"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Selah Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Selah Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.