NPIMap

Organization Active NPI

Lutheran Social Services of the South, Inc.

Doing business as Upbring - DMST Austin

  • Professional Counselor
  • Austin, TX
National Provider Identifier
1669084943
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
LUTHERAN SOCIAL SERVICES OF THE SOUTH, INC.
Doing business as
Upbring - DMST Austin
Practice address
10601 Derecho Drive
Austin, TX 78737-1013
Phone
(512) 459-1000
Fax
(512) 706-7576
NPI assigned
Aug 19, 2020
Organization subpart
Yes
Parent organization
LUTHERAN SOCIAL SERVICES OF THE SOUTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Authorized official

Name
Ms. Krystale Bezio, MSW, LCPAA
Title
Chief Program Officer
Phone
(512) 459-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

10601 Derecho Drive
Austin, TX 78737-1013

Mailing address

8305 Cross Park Drive
Austin, TX 78754-5154
Phone (512) 459-1000

Other names 1

  • Upbring - DMST Austin Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Social Services of the South Inc11 organizations share this tax ID, including this one
Part of
Lutheran Social Services of the South Inc

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1669084943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8305 CROSS PARK DRIVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787545154",
            "telephone_number": "512-459-1000",
            "fax_number": "512-706-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 DERECHO DRIVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787371013",
            "telephone_number": "512-459-1000",
            "fax_number": "512-706-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICES OF THE SOUTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUTHERAN SOCIAL SERVICES OF THE SOUTH",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "BEZIO",
        "authorized_official_first_name": "KRYSTALE",
        "authorized_official_title_or_position": "CHIEF PROGRAM OFFICER",
        "authorized_official_telephone_number": "512-459-1000",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, LCPAA"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upbring - DMST Austin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 19, 2020; 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.