Blake Bryant, LCSW

Primary specialty

CounselorTaxonomy code 101Y00000X

License

69071 Issued in TX

Practice address

1309 Byers LN
Austin, TX 78753-6890

Phone

(214) 794-1997

NPI assigned

Mar 27, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1023869294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 BYERS LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787536890",
            "telephone_number": "214-794-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 BYERS LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787536890",
            "telephone_number": "214-794-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "BLAKE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "69071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Nick Bryan, MD
• William Augustus Bryan, ACNS-BC
• Allison Bryant
• Amy Elizabeth Bryant, LPC-ASSOCIATE
• Ben Austin Bryant, LCSW
• Brittany Bryant
• Deborah Bryant, OTR/L
• Destiny Bryant
• Eve Bryant, RPH
• Grace Wilkowski Bryant, M.D.

• Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.