Individual provider Active NPI

Juliane Taylor Shore, LPC, LMFTA

  • Professional Counselor
  • Austin, TX
National Provider Identifier
1962787929
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
65532 Issued in TX
Practice address
3625 Manchaca Rd
Suite 102
Austin, TX 78704-6631
Phone
(512) 653-0564
Fax
(512) 443-4844
NPI assigned
Oct 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 65532 TX Primary
Marriage & Family Therapist 106H00000X 201454 TX

Addresses

Primary practice location

3625 Manchaca Rd
Suite 102
Austin, TX 78704-6631

Mailing address

3625 Manchaca Rd
Suite 102
Austin, TX 78704-6631
Phone (512) 653-0564

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

LicenseStateTypeSpecialty
201454TXMDMarriage & Family Therapist
65532TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1962787929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 MANCHACA RD",
            "address_2": "SUITE 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787046631",
            "telephone_number": "512-653-0564",
            "fax_number": "512-443-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 MANCHACA RD",
            "address_2": "SUITE 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787046631",
            "telephone_number": "512-653-0564",
            "fax_number": "512-443-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "JULIANE",
        "middle_name": "TAYLOR",
        "name_prefix": "Ms.",
        "credential": "LPC, LMFTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "65532",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "201454",
            "primary": false
        }
    ],
    "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 Oct 20, 2011; 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.