J and M Etccc

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

12569 Issued in TX

Legal business name

J AND M ETCCC

Practice address

105 E Janis Dr
Georgetown, TX 78628-3615

Phone

(512) 591-7130

Fax

(512) 591-7130

NPI assigned

May 4, 2009

Last updated

May 4, 2009By 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

Mr. Michael Dave Halligan, L.P.C.NPI 1790943561

Title

Co/Owner

Phone

(512) 591-7130

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Michael Halligan, LPC

  • Professional Counselor
  • Georgetown, TX
  • NPI 1790943561
  NPD (past) Authorized official

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241395200000",
    "number": "1588898787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E JANIS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283615",
            "telephone_number": "512-591-7130",
            "fax_number": "512-591-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E JANIS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283615",
            "telephone_number": "512-591-7130",
            "fax_number": "512-591-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J AND M ETCCC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-04",
        "last_updated": "2009-05-04",
        "status": "A",
        "authorized_official_last_name": "HALLIGAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVE",
        "authorized_official_title_or_position": "CO/OWNER",
        "authorized_official_telephone_number": "512-591-7130",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.P.C."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "12569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "12569",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; 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.