Individual provider Active NPI

Sally Mayo, LPC

  • Professional Counselor
  • Austin, TX
National Provider Identifier
1336724624
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
79953 Issued in TX
Practice address
4411 Spicewood Springs Rd Apt 1103
Austin, TX 78759-8573
Phone
(512) 750-3323
NPI assigned
Mar 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 79953 TX Primary

Addresses

Primary practice location

4411 Spicewood Springs Rd Apt 1103
Austin, TX 78759-8573

Mailing address

4411 Spicewood Springs Rd Apt 1103
Austin, TX 78759-8573
Phone (512) 750-3323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 13, 2024 through May 13, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
79953TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1336724624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 SPICEWOOD SPRINGS RD APT 1103",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598573",
            "telephone_number": "512-750-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 SPICEWOOD SPRINGS RD APT 1103",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598573",
            "telephone_number": "512-750-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "SALLY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.