Liza Potapenko Psy.D. LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

36269 Issued in TX

Legal business name

LIZA POTAPENKO PSY.D. LLC

Practice address

2111 Dickson Dr Ste 10
Austin, TX 78704-4788

Phone

(512) 710-7203

NPI assigned

May 2, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Elizaveta Potapenko, PSY.D.

Title

President

Phone

(512) 710-7203

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525219200000",
    "number": "1629567904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 DICKSON DR STE 10",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787044788",
            "telephone_number": "512-710-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 DICKSON DR STE 10",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787044788",
            "telephone_number": "512-710-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIZA POTAPENKO PSY.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-02",
        "last_updated": "2018-05-02",
        "status": "A",
        "authorized_official_last_name": "POTAPENKO",
        "authorized_official_first_name": "ELIZAVETA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-710-7203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "TX",
            "license": "36269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Austin, TX
• Adult Mental Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; 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.