Active NPI
Kerry Mecusker, LCSW
- Counselor
- Austin, TX
National Provider Identifier
1972259885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 55497
- Practice address
- 5900 Balcones Dr Ste 100
Austin, TX 78731-4298 - Phone
- (512) 689-7518
- NPI assigned
- Mar 1, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 55497 | TX | Primary |
Addresses
Primary practice location
5900 Balcones Dr Ste 100
Austin, TX 78731-4298
Mailing address
5900 Balcones Dr Ste 100
Austin, TX 78731-4298
Phone (512) 689-7518
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 |
|---|---|---|---|
| 55497 | TX | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inner Life Counseling LLC | Counselor | Current | Accepting new patients |
Locations
5900 Balcones Dr
Ste 100
Austin, TX 78731
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Counselor
- Austin, TX
- NPI 1609529601
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1972259885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 BALCONES DR STE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787314298",
"telephone_number": "512-689-7518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 BALCONES DR STE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787314298",
"telephone_number": "512-689-7518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MECUSKER",
"first_name": "KERRY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-01",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "55497",
"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 1, 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.