| Austin Vitality Counseling | |
|
12502 Palfrey Dr Austin TX 78727-3017 | |
| (512) 422-4352 | |
| Not Available |
| Full Name | Austin Vitality Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 12502 Palfrey Dr, Austin, Texas |
| Authorized Official Name and Position | Carlye Johnston Levine (MANAGER) |
| Authorized Official Contact | 5124224352 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Austin Vitality Counseling 12502 Palfrey Dr Austin TX 78727-3017 Ph: (512) 422-4352 | Austin Vitality Counseling 12502 Palfrey Dr Austin TX 78727-3017 Ph: (512) 422-4352 |
| NPI Number | 1770070070 |
|---|---|
| Provider Enumeration Date | 04/23/2018 |
| Last Update Date | 04/23/2018 |
| Medicare PECOS PAC ID | 6406103928 |
|---|---|
| Medicare Enrollment ID | O20180716000824 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770070070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 52338 (Texas) | Primary |
| Provider Name | Shannon L Dennis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528115128 PECOS PAC ID: 8325937857 Enrollment ID: I20040312000881 |
| Provider Name | Carlye J Levine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164961496 PECOS PAC ID: 4587931175 Enrollment ID: I20170602000832 |
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