Active NPI
Theodore A Carlos, M.A.,LPC
- Professional Counselor
- Austin, TX
National Provider Identifier
1598840290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 14312
- Practice address
- 4131 Spicewood Springs Rd
Suite K-6
Austin, TX 78759-8661 - Phone
- (512) 789-3382
- Fax
- (866) 348-5297
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 14312 | TX | Primary |
Addresses
Primary practice location
4131 Spicewood Springs Rd
Suite K-6
Austin, TX 78759-8661
Mailing address
4131 Spicewood Springs Rd
Suite K-6
Austin, TX 78759-8661
Phone (512) 789-3382
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6042LC | Other | TX | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240206003505 | TX | Practitioner - Mental Health Counselor | 3678916731 | Practice locations: Austin, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4131 Spicewood Springs Rd
Suite C4
Austin, TX 78759-8658
Phone (512) 789-3382
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14312 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598840290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4131 SPICEWOOD SPRINGS RD",
"address_2": "SUITE K-6",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787598661",
"telephone_number": "512-789-3382",
"fax_number": "866-348-5297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4131 SPICEWOOD SPRINGS RD",
"address_2": "SUITE K-6",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787598661",
"telephone_number": "512-789-3382",
"fax_number": "866-348-5297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLOS",
"first_name": "THEODORE",
"middle_name": "A",
"credential": "M.A.,LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "14312",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "6042LC",
"state": "TX"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.