Individual provider Active NPI

Ashley D Coulter, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1548771884
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
63183 Issued in TX
Practice address
10011 Stonelake Blvd Apt 366
Austin, TX 78759-6097
Phone
(682) 302-1338
Fax
(682) 206-3463
NPI assigned
Oct 13, 2017
Last updated
Sep 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 63183 TX Primary

Addresses

Primary practice location

10011 Stonelake Blvd Apt 366
Austin, TX 78759-6097

Mailing address

10011 Stonelake Blvd Apt 366
Austin, TX 78759-6097
Phone (682) 302-1338

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

State licenses

LicenseStateTypeSpecialty
63183TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Authentic & Intentional Minds, PLLC CurrentSince Oct 5, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1548771884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10011 STONELAKE BLVD APT 366",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787596097",
            "telephone_number": "682-302-1338",
            "fax_number": "682-206-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10011 STONELAKE BLVD APT 366",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787596097",
            "telephone_number": "682-302-1338",
            "fax_number": "682-206-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "ASHLEY",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-13",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "63183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.