NPIMap

Organization Active NPI

Lake Travis Counseling Connection PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lakeway, TX
National Provider Identifier
1396209052
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LAKE TRAVIS COUNSELING CONNECTION PLLC
Practice address
311 Ranch Road 620 S Ste 105
Lakeway, TX 78734-4747
Phone
(512) 263-4200
Fax
(512) 233-2867
NPI assigned
Jan 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Authorized official

Name
Ms. Jan Shope, LPC-SNPI 1417235763
Title
Owner/Clinical Director
Phone
(512) 263-4200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

311 Ranch Road 620 S Ste 105
Lakeway, TX 78734-4747

Mailing address

311 Ranch Road 620 S Ste 105
Lakeway, TX 78734-4747
Phone (512) 263-4200

National Provider Directory

National Provider Directory

Locations

311 Ranch Road 620 S
Ste 105
Lakeway, TX 78734
Phone (512) 956-6970

Practitioners & affiliated clinicians

Practitioners 5

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": "1548633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548633600000",
    "number": "1396209052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 RANCH ROAD 620 S STE 105",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787344747",
            "telephone_number": "512-263-4200",
            "fax_number": "512-233-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 RANCH ROAD 620 S STE 105",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787344747",
            "telephone_number": "512-263-4200",
            "fax_number": "512-233-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE TRAVIS COUNSELING CONNECTION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-28",
        "last_updated": "2019-01-28",
        "status": "A",
        "authorized_official_last_name": "SHOPE",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "512-263-4200",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC-S"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeway, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.