Nicole Austin, LPC

Key facts

NPI

1497906390

Entity type

Individual (NPI type 1)

Primary specialty

Professional Counselor 101YP2500X

License

13823 (TX)

Practice address

121 Old San Antonio Rd
Boerne, TX 78006-3415

Phone

(830) 816-2425

Fax

(830) 249-8714

NPI assigned

Oct 9, 2008

Sex

Female

Sole proprietor

No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Roy Maas' Youth Alternatives, Inc. Clinical Social Worker · Boerne, TX · NPI 1083774046
  NPD (past) PROFESSIONAL

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 9, 2008.

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223510400000",
    "number": "1497906390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 WEST AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134535",
            "telephone_number": "210-340-8077",
            "fax_number": "210-340-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 OLD SAN ANTONIO RD",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063415",
            "telephone_number": "830-816-2425",
            "fax_number": "830-249-8714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-09",
        "last_updated": "2008-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "13823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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