Individual provider Active NPI

Judy Ann Sutton, LPC-S, LBA, BCBA

  • Behavior Analyst
  • Austin, TX
National Provider Identifier
1316056476
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-09-5158 Issued in TX
Practice address
1779 Wells Branch Parkway Suite 110B-194
Austin, TX 78728
Phone
(512) 872-1884
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 12500 TX
Behavior Analyst 103K00000X 1-09-5158 FL
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1078 TX
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1-09-5158 TX Primary

Addresses

Primary practice location

1779 Wells Branch Parkway Suite 110B-194
Austin, TX 78728

Mailing address

1779 Wells Branch Parkway Suite 110B-194
Austin, TX 78728
Phone (512) 872-1884

Other identifiers 2

IdentifierTypeStateIssuer
131605476MedicaidTN
027756802MedicaidTX

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

State licenses

LicenseStateTypeSpecialty
12500TXMDProfessional Counselor
1078TXMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1316056476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1779 WELLS BRANCH PARKWAY SUITE 110B-194",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78728",
            "telephone_number": "512-872-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1779 WELLS BRANCH PARKWAY SUITE 110B-194",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78728",
            "telephone_number": "512-872-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "JUDY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LPC-S, LBA, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "12500",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-09-5158",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1078",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-09-5158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131605476",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027756802",
            "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 28, 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.

Verify at the official NPI Registry.