Active NPI
John Mark Haney, PHD, LPC
- Counselor
- Austin, TX
National Provider Identifier
1306040118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 19095
- Practice address
- 4131 Spicewood Springs Rd Ste O3
Austin, TX 78759-8664 - Phone
- (512) 346-9299
- Fax
- (512) 264-3729
- NPI assigned
- Jun 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 19095 | TX | Primary |
Addresses
Primary practice location
4131 Spicewood Springs Rd Ste O3
Austin, TX 78759-8664
Mailing address
1912 Shadowbrook Cir
Round Rock, TX 78681-7139
Phone (512) 388-4172
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | TX |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19095 | TX | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306040118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1912 SHADOWBROOK CIR",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786817139",
"telephone_number": "512-388-4172",
"fax_number": "512-264-3729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4131 SPICEWOOD SPRINGS RD STE O3",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787598664",
"telephone_number": "512-346-9299",
"fax_number": "512-264-3729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANEY",
"first_name": "JOHN",
"middle_name": "MARK",
"name_prefix": "Mr.",
"credential": "PHD, LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "19095",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "TX"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.