NPIMap

Organization Active NPI

Upside Wellness, PLLC

  • Professional Counselor
  • Austin, TX
National Provider Identifier
1336534882
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
72859 Issued in TX
Legal business name
UPSIDE WELLNESS, PLLC
Practice address
3705 Medical Pkwy Ste 520
Austin, TX 78705-1029
Phone
(512) 900-5805
Fax
(512) 287-4314
NPI assigned
Apr 1, 2015
Last updated
Apr 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Authorized official

Name
Thomas Lane Ingram, LPCNPI 1760875058
Title
Owner
Phone
(512) 900-5805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 72859 TX Primary

Addresses

Primary practice location

3705 Medical Pkwy Ste 520
Austin, TX 78705-1029

Mailing address

3705 Medical Pkwy Ste 520
Austin, TX 78705-1029
Phone (512) 900-5805

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1336534882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 MEDICAL PKWY STE 520",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051029",
            "telephone_number": "512-900-5805",
            "fax_number": "512-287-4314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 MEDICAL PKWY STE 520",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051029",
            "telephone_number": "512-900-5805",
            "fax_number": "512-287-4314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSIDE WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-01",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-900-5805",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "72859",
            "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 Apr 1, 2015; 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.