Active NPI
Mohadev Bhattacharyya, LPC
- Mental Health Counselor
- Austin, TX
National Provider Identifier
1821850751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 79550
- Practice address
- 4422 Pack Saddle Pass Ste 102
Austin, TX 78745-1644 - Phone
- (512) 566-4528
- NPI assigned
- Jan 25, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 79550 | TX | Primary |
Addresses
Primary practice location
4422 Pack Saddle Pass Ste 102
Austin, TX 78745-1644
Mailing address
3104 Matador Dr
Austin, TX 78741-7061
Phone (979) 402-2017
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79550 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706140800000",
"number": "1821850751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3104 MATADOR DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787417061",
"telephone_number": "979-402-2017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4422 PACK SADDLE PASS STE 102",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787451644",
"telephone_number": "512-566-4528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BHATTACHARYYA",
"first_name": "MOHADEV",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-01-25",
"last_updated": "2024-01-25",
"certification_date": "2024-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "79550",
"primary": true
}
],
"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 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.