Infinite Wellness Austin PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

58367 Issued in TX

Legal business name

INFINITE WELLNESS AUSTIN PLLC

Practice address

1011 Meredith Dr Ste 12
Austin, TX 78748-3763

Phone

(512) 703-0642

NPI assigned

Mar 1, 2018

Last updated

May 29, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Analisa Reyes, LCSW, LCDCNPI 1598195224

Title

Owner, Therapist

Phone

(512) 703-0642

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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.

• Analisa Reyes, LCSW, LCDC

  • Clinical Social Worker
  • Austin, TX
  • NPI 1598195224
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590710400000",
    "number": "1841792215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734",
            "city": "MANCHACA",
            "state": "TX",
            "postal_code": "786520734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 MEREDITH DR STE 12",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787483763",
            "telephone_number": "512-703-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITE WELLNESS AUSTIN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-01",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "ANALISA",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "512-703-0642",
        "authorized_official_credential": "LCSW, LCDC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12526",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "58367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.