Active NPI
Kenneth Dobbins Jr., LPC
- Professional Counselor
- Austin, TX
National Provider Identifier
1609597251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 84973
- Practice address
- 5301 Decker LN Apt 2311
Austin, TX 78724-5826 - Phone
- (512) 253-1260
- NPI assigned
- Sep 12, 2022
- Last updated
- Sep 12, 2022
- 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 | 84973 | TX | Primary |
Addresses
Primary practice location
5301 Decker LN Apt 2311
Austin, TX 78724-5826
Mailing address
1801 E 51St Street
BLDG C Ste 365 #240
Austin, TX 78723
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.Simplepractice.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 84973 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1609597251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 E 51ST STREET",
"address_2": "BLDG C STE 365 #240",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 DECKER LN APT 2311",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787245826",
"telephone_number": "512-253-1260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOBBINS",
"first_name": "KENNETH",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-12",
"last_updated": "2022-09-12",
"certification_date": "2022-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "84973",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.Simplepractice.com",
"affiliation": "N",
"address_1": "5301 Decker Ln Apt 2311",
"city": "Austin",
"state": "TX",
"country_code": "US",
"postal_code": "787245826",
"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 Sep 12, 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.