Organization Active NPI

Wise Mind Austin, PLLC

  • Adult Mental Health Clinic/Center
  • Loveland, CO
National Provider Identifier
1679034755
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
WISE MIND AUSTIN, PLLC
Practice address
5008 Ranch Acres Dr
Loveland, CO 80538-1638
Phone
(512) 665-3499
NPI assigned
Mar 29, 2019
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Daniel Brake, MA, LMFT-SNPI 1336511377
Title
Owner
Phone
(512) 665-3499

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

5008 Ranch Acres Dr
Loveland, CO 80538-1638

Mailing address

2028E Ben White Blvd
Ste 240 PMB 3499
Austin, TX 78741-6931
Phone (512) 665-3499

National Provider Directory

National Provider Directory

Locations

2028 E Ben White Blvd
Ste 240
Austin, TX 78741

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1679034755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028E BEN WHITE BLVD",
            "address_2": "STE 240 PMB 3499",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787416931",
            "telephone_number": "512-665-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 RANCH ACRES DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805381638",
            "telephone_number": "512-665-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE MIND AUSTIN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-29",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "BRAKE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-665-3499",
        "authorized_official_credential": "MA, LMFT-S"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.