Active NPI
Michael Mahan, LCSW, LCDC
- Addiction (Substance Use Disorder) Counselor
- Austin, TX
National Provider Identifier
1730634072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 11603
- Practice address
- 6633 E Highway 290
Suite 212
Austin, TX 78723-1172 - Phone
- (512) 342-1718
- NPI assigned
- Aug 16, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 11603 | TX | Primary |
| Clinical Social Worker | 1041C0700X | 55657 | TX |
Addresses
Primary practice location
6633 E Highway 290
Suite 212
Austin, TX 78723-1172
Mailing address
6633 E Highway 290
Suite 212
Austin, TX 78723-1172
Phone (512) 342-1718
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11603 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471305600000",
"number": "1730634072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6633 E HIGHWAY 290",
"address_2": "SUITE 212",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787231172",
"telephone_number": "512-342-1718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6633 E HIGHWAY 290",
"address_2": "SUITE 212",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787231172",
"telephone_number": "512-342-1718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHAN",
"first_name": "MICHAEL",
"credential": "LCSW, LCDC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-16",
"last_updated": "2016-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "11603",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "55657",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"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 Aug 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.