Pedersen Counseling PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PEDERSEN COUNSELING PLLC

Practice address

317 Copperleaf Rd
Lakeway, TX 78734-4246

Phone

(512) 963-3660

NPI assigned

Jun 12, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Kelly L Pedersen, LPC-SNPI 1497872493

Title

Owner/Psychotherapist

Phone

(512) 963-3660

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Kelly Leigh Pedersen, LPC

  • Professional Counselor
  • Lakeway, TX
  • NPI 1497872493
  NPD Authorized official

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

{
    "created_epoch": "1654992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654992000000",
    "number": "1104556364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 COPPERLEAF RD",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787344246",
            "telephone_number": "512-963-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 COPPERLEAF RD",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787344246",
            "telephone_number": "512-963-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDERSEN COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-12",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "512-963-3660",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC-S"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MY NPI TYPE 1 NUMBER - SOLE PRORIETOR",
            "identifier": "1497872493",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YP2500X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rakesh Patel, MD
• Tejas N Patel, DDS
• Lynne Marie Patzelt, NBC-HWC
• William David Payne Jr., M.D.
• Kristi Dawn Payton, MS, CCC-SLP
• Kelly Leigh Pedersen, LPC
• Pelvic Protocol PLLC
• Sonia Anna Penaroza, AU.D.
• Pennington Psychology, PLLC
• Charlotte Pennington

• Mental Health Clinic/Center (Including Community Mental Health Center) in Lakeway, TX
• Providers in Lakeway, TX by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.