Restore FX

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

F5318 Issued in TX

Legal business name

RESTORE FX

Practice address

4534 W Gate Blvd
Suite 112
Austin, TX 78745-1485

Phone

(512) 439-7360

NPI assigned

Feb 8, 2008

Last updated

Oct 22, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tykeisha P. Sims

Title

Administrator

Phone

(512) 334-2149

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1467630608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4534 W GATE BLVD",
            "address_2": "SUITE 112",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451485",
            "telephone_number": "512-439-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4534 W GATE BLVD",
            "address_2": "SUITE 112",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451485",
            "telephone_number": "512-439-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE FX",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-08",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "TYKEISHA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "512-334-2149"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "F5318",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "26883",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "34223",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1132165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Restored Family Counseling, PLLC
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• Restoring Lives 365, PLLC
• Resurface Group of Austin PLLC
• Resurgence Inc.

• Addiction (Substance Use Disorder) Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.