Organization Active NPI

Art Full Life Austin PLLC

  • Professional Counselor
  • Cedar Park, TX
National Provider Identifier
1013452663
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
15229 Issued in TX
Legal business name
ART FULL LIFE AUSTIN PLLC
Practice address
1101 Arrow Point Dr Ste 207
Cedar Park, TX 78613-7739
Phone
(512) 636-9838
NPI assigned
Jan 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Authorized official

Name
Ms. Alice E Green, LPC AT/S, ATR-BCNPI 1154649416
Title
Owner
Phone
(512) 636-9838

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 15229 TX Primary

Addresses

Primary practice location

1101 Arrow Point Dr Ste 207
Cedar Park, TX 78613-7739

Mailing address

1005 Little Elm Park
Austin, TX 78758-6712
Phone (512) 636-9838

Other identifiers 1

IdentifierTypeStateIssuer
351294901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240611000127 TX Part B Supplier - Clinic/Group Practice 9638611262 Receives reassigned benefits from 1 practitioner
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

12741 Research Blvd
Ste 300
Austin, TX 78759
Phone (512) 331-6005

Practitioners & affiliated clinicians

Practitioners 3

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": "1483574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483574400000",
    "number": "1013452663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 LITTLE ELM PARK",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787586712",
            "telephone_number": "512-636-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 ARROW POINT DR STE 207",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137739",
            "telephone_number": "512-636-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ART FULL LIFE AUSTIN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-01-05",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-636-9838",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC AT/S, ATR-BC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "15229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "351294901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.