Individual provider Active NPI

Stephen Waller-de la Rosa, LPC

  • Professional Counselor
  • Austin, TX
National Provider Identifier
1851186167
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
85790 Issued in TX
Practice address
5900 Balcones Dr # 8493
Austin, TX 78731-4257
Phone
(512) 348-7398
NPI assigned
Apr 9, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 85790 TX Primary

Addresses

Primary practice location

5900 Balcones Dr # 8493
Austin, TX 78731-4257

Mailing address

5900 Balcones Dr # 8493
Austin, TX 78731-4257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 8, 2024 through May 8, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
85790TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1851186167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR # 8493",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR # 8493",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314257",
            "telephone_number": "512-348-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER-DE LA ROSA",
        "first_name": "STEPHEN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "85790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.