Active NPI
Stephen Waller-de la Rosa, LPC
- Professional Counselor
- Austin, TX
National Provider Identifier
1851186167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 85790
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 85790 | TX | MD | Professional 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.