NPIMap

Organization Active NPI

Spearhead Lodge, LLC

  • Addiction (Substance Use Disorder) Counselor
  • Austin, TX
National Provider Identifier
1093260002
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
4085-4086 Issued in TX
Legal business name
SPEARHEAD LODGE, LLC
Practice address
8455 Lyndon LN
Austin, TX 78729-3704
Phone
(512) 278-4940
NPI assigned
Aug 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Authorized official

Name
Amanda Kay Baker, MS,LCDCNPI 1811369671
Title
President
Phone
(972) 835-1963

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
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X 4085-4086 TX Primary

Addresses

Primary practice location

8455 Lyndon LN
Austin, TX 78729-3704

Mailing address

8455 Lyndon LN
Austin, TX 78729-3704
Phone (512) 278-4940

National Provider Directory

National Provider Directory

Locations

8455 Lyndon Ln
Austin, TX 78729
Phone (512) 278-4936

Practitioners & affiliated clinicians

Practitioners 4

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": "1471564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1093260002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8455 LYNDON LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787293704",
            "telephone_number": "512-278-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8455 LYNDON LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787293704",
            "telephone_number": "512-278-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEARHEAD LODGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-19",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-835-1963",
        "authorized_official_credential": "MS,LCDC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "4085-4086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 13, 2022; 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.