Jennifer Merrill Baca Davila, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

71881 Issued in TX

Practice address

13740 Research Blvd Ste N8
Austin, TX 78750-1834

Phone

(512) 939-7769

Fax

(512) 939-7769

NPI assigned

Jul 14, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Merrill Baca Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Deep Waters Austin LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Austin, TX
  • NPI 1023534294
  NPD Authorized official

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1578085171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13740 RESEARCH BLVD STE N8",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501834",
            "telephone_number": "512-939-7769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13740 RESEARCH BLVD STE N8",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501834",
            "telephone_number": "512-939-7769",
            "fax_number": "512-939-7769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "813 W 11th St Ste B",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787012058",
            "country_code": "US",
            "telephone_number": "512-939-7769",
            "fax_number": "512-939-7769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACA DAVILA",
        "first_name": "JENNIFER",
        "middle_name": "MERRILL",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "71881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BACA",
            "middle_name": "MERRILL",
            "credential": "JENNIFER BACA, LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Babylon Health, PLLC
• Babylon Healthcare Inc.
• Babylon Healthcare Inc.
• Babylon Healthcare, P.C.
• Babylon Healthcare, PLLC
• Elijah Baca
• Waleska Citlaly Baca
• Fareeda Bacchus, DDS, MS
• Taylor Baccus, PA-C
• Caroline Bach

• Mental Health Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.