Active NPI
Alan George Waisanen, MS, LPC, LMFT
- Professional Counselor
- Austin, TX
National Provider Identifier
1326410424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 69304
- Practice address
- 3625 Manchaca Rd
Suite 303
Austin, TX 78704-6631 - Phone
- (512) 413-4497
- NPI assigned
- Oct 28, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | 69304 | TX | Primary |
| Marriage & Family Therapist | 106H00000X | 202091 | TX |
Addresses
Primary practice location
3625 Manchaca Rd
Suite 303
Austin, TX 78704-6631
Mailing address
4010 Sendero Dr
Austin, TX 78735-6316
Phone (512) 413-4497
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69304 | TX | MD | Professional Counselor |
| 202091 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472428800000",
"number": "1326410424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4010 SENDERO DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787356316",
"telephone_number": "512-413-4497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3625 MANCHACA RD",
"address_2": "SUITE 303",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787046631",
"telephone_number": "512-413-4497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAISANEN",
"first_name": "ALAN",
"middle_name": "GEORGE",
"credential": "MS, LPC, LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-10-28",
"last_updated": "2016-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "69304",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "202091",
"primary": false
}
],
"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 Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.