Active NPI
Leslie Mellenbruch, M.S., L.P.C.
- Professional Counselor
- Bastrop, TX
National Provider Identifier
1386083392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 15878
- Practice address
- 944 Highway 71 E
Suite 110-1
Bastrop, TX 78602-5023 - Phone
- (512) 924-8555
- NPI assigned
- Jun 24, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 15878 | TX | Primary |
Addresses
Primary practice location
944 Highway 71 E
Suite 110-1
Bastrop, TX 78602-5023
Mailing address
PO Box 1631
Bastrop, TX 78602-8631
Phone (512) 924-8555
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 |
|---|---|---|---|
| 15878 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372032000000",
"number": "1386083392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1631",
"city": "BASTROP",
"state": "TX",
"postal_code": "786028631",
"telephone_number": "512-924-8555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "944 HIGHWAY 71 E",
"address_2": "SUITE 110-1",
"city": "BASTROP",
"state": "TX",
"postal_code": "786025023",
"telephone_number": "512-924-8555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLENBRUCH",
"first_name": "LESLIE",
"name_prefix": "Mrs.",
"credential": "M.S., L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-24",
"last_updated": "2013-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "15878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bastrop, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.