Active NPI
Marisa Malik
- Professional Counselor
- Austin, TX
National Provider Identifier
1609290378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 67598
- Practice address
- 1430 Collier St
Austin, TX 78704-2911 - Phone
- (512) 472-4357
- Fax
- (512) 703-1394
- NPI assigned
- Feb 14, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 67598 | TX | |
| Professional Counselor | 101YP2500X | 67598 | TX | Primary |
Addresses
Primary practice location
1430 Collier St
Austin, TX 78704-2911
Mailing address
1430 Collier St
Austin, TX 78704-2911
Phone (512) 472-4357
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609290378 | Medicaid | TX |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Marisa.Malik@integralcare.org | Direct | Austin Travis County Integral Care |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67598 | TX | MD | Mental Health Counselor |
Interoperability endpoints
- marisa.malik@integralcare.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1609290378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1430 COLLIER ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787042911",
"telephone_number": "512-472-4357",
"fax_number": "512-703-1394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1430 COLLIER ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787042911",
"telephone_number": "512-472-4357",
"fax_number": "512-703-1394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALIK",
"first_name": "MARISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-14",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "67598",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "67598",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1609290378",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Marisa.Malik@integralcare.org",
"affiliation": "Y",
"endpointDescription": "Business email",
"affiliationName": "Austin Travis County Integral Care",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1430 Collier St",
"city": "Austin",
"state": "TX",
"country_code": "US",
"postal_code": "787042911",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.