Active NPI
Kaitlin Clancy, MA
- Mental Health Counselor
- Austin, TX
National Provider Identifier
1184226268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 83910
- Practice address
- 8500 N Mopac Expy Ste 402
Austin, TX 78759-8347 - Phone
- (512) 902-3282
- NPI assigned
- Nov 12, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 83910 | TX | |
| Mental Health Counselor | 101YM0800X | 83910 | TX | Primary |
Addresses
Primary practice location
8500 N Mopac Expy Ste 402
Austin, TX 78759-8347
Mailing address
91 Rainey St Apt 318
Austin, TX 78701-0049
Phone (214) 236-3208
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83910 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605139200000",
"number": "1184226268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 RAINEY ST APT 318",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787010049",
"telephone_number": "214-236-3208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8500 N MOPAC EXPY STE 402",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787598347",
"telephone_number": "512-902-3282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLANCY",
"first_name": "KAITLIN",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-12",
"last_updated": "2020-11-12",
"certification_date": "2020-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "83910",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "83910",
"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 Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.