John G. Sudduth, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

85038 Issued in TX

Practice address

502 E Highland Mall Blvd
Austin, TX 78752-3722

Phone

(512) 854-5274

NPI assigned

Sep 23, 2024

Sex

Male

Sole proprietor

No

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Austin Travis County Mental Health and Mental Retardation Center

  • Psychiatry Physician
  • Austin, TX
  • NPI 1750337259

  Professional

  Medicare reassignment NPD
• Austin Travis County Mental Health and Mental Retardation Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Austin, TX
  • NPI 1053632505
  NPD

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1235956236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 DELAFIELD LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787521310",
            "telephone_number": "940-206-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E HIGHLAND MALL BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523722",
            "telephone_number": "512-854-5274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7505 Delafield Ln",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787521310",
            "country_code": "US",
            "telephone_number": "940-206-6879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUDDUTH",
        "first_name": "JOHN",
        "middle_name": "G.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "85038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kittisak Subphachaisirikul, RPH
• Revathy Subramany, M.D
• Substance Abuse Intervention & Learning (Sail)
• Successful Smiles of Texas
• Crystal Suchyta, LPC
• Jared Dewayne Sudekum
• Sarita Sudermann, RD
• Connie Suen, PHARMD
• Cressida Suess, PH.D.
• Rebecca Auguste Suffness, PHD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.