Individual provider Active NPI

Bethany M Sirevicius, LPC, LCDC

  • Professional Counselor
  • Austin, TX
National Provider Identifier
1629485693
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
87881 Issued in TX
Practice address
2501 W William Cannon Dr Ste 401
Austin, TX 78745-5278
Phone
(512) 804-3210
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 87881 TX Primary

Addresses

Primary practice location

2501 W William Cannon Dr Ste 401
Austin, TX 78745-5278

Mailing address

1430 Collier St
Austin, TX 78704-2911
Phone (512) 472-4357

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109000097 TX Practitioner - Mental Health Counselor 3173974789 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
87881TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Travis County Mental Health and Mental Retardation Center CurrentSince Jan 1, 2024 Accepting new patients
Hill Country Community MHMR Center CurrentSince Feb 16, 2025 Accepting new patients
Austin Travis County Mental Health and Mental Retardation Center Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

1430 Collier St
Austin, TX 78704
Phone (512) 427-4357

1631 E 2nd St
Ste A
Austin, TX 78702
Phone (512) 804-3380

2501 W William Cannon Dr
Bldg 4
Austin, TX 78745
Phone (512) 804-3200

819 Water St
Ste 300
Kerrville, TX 78028
Phone (830) 258-5430

1300 Dacy Ln
Ste 120
Kyle, TX 78640
Phone (512) 392-8953

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1629485693",
    "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": "2501 W WILLIAM CANNON DR STE 401",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455278",
            "telephone_number": "512-804-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIREVICIUS",
        "first_name": "BETHANY",
        "middle_name": "M",
        "credential": "LPC, LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "87881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.