| Texas Mentor | |
|
4150 Freidrich Ln Bldg N Suite G Austin TX 78744-1800 | |
| (512) 326-8866 | |
| (512) 326-4102 |
| Full Name | Texas Mentor |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4150 Freidrich Ln Bldg N, Austin, Texas |
| Authorized Official Name and Position | Brett Ian Cohen (COO) |
| Authorized Official Contact | 8003885150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Mentor 313 Congress St Boston MA 02210-1218 Ph: (800) 388-5150 | Texas Mentor 4150 Freidrich Ln Bldg N Suite G Austin TX 78744-1800 Ph: (512) 326-8866 |
| NPI Number | 1861607186 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 03/19/2023 |
| Certification Date | 03/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861607186 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 30997 (Texas) | Primary |
| 251B00000X | Case Management | 0000H08EW (Texas) | Secondary |
| 253J00000X | Foster Care Agency | 0000H08EW (Texas) | Secondary |
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