Active NPI
Simon Niblock, MA
- Marriage & Family Therapist
- Austin, TX
National Provider Identifier
1992251128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 202745
- Practice address
- 1004 Mopac Cir
Suite 100
Austin, TX 78746 - Phone
- (512) 470-6976
- NPI assigned
- Aug 28, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 202745 | TX | Primary |
Addresses
Primary practice location
1004 Mopac Cir
Suite 100
Austin, TX 78746
Mailing address
4317 Manzanillo Dr
Austin, TX 78749-3846
Phone (512) 897-2551
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202745 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472342400000",
"number": "1992251128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4317 MANZANILLO DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787493846",
"telephone_number": "512-897-2551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1004 MOPAC CIR",
"address_2": "SUITE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78746",
"telephone_number": "512-470-6976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIBLOCK",
"first_name": "SIMON",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-28",
"last_updated": "2016-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "202745",
"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 Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.