Southern Beacon Therapy PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SOUTHERN BEACON THERAPY PLLC

Practice address

7700 W Highway 71 Ste 170
Austin, TX 78735-8272

Phone

(737) 242-8700

NPI assigned

Dec 18, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Katelyn Williams, MA, LPC, NCC, RPTNPI 1255894341

Title

Owner/Therapist

Phone

(737) 242-8700

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katelyn Williams, MA, NCC, LPC

  • Professional Counselor
  • Austin, TX
  • NPI 1255894341
  NPD Authorized official

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1811583289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 LYNNBROOK DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787482128",
            "telephone_number": "210-415-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 W HIGHWAY 71 STE 170",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358272",
            "telephone_number": "737-242-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN BEACON THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KATELYN",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "737-242-8700",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, LPC, NCC, RPT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.