Provider Demographics
NPI:1306403266
Name:AUSTIN COUNSELING AND TRAUMA SPECIALISTS, PLLC
Entity type:Organization
Organization Name:AUSTIN COUNSELING AND TRAUMA SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:KAUITZSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:512-731-1395
Mailing Address - Street 1:3000 POLAR LN STE 501
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3073
Mailing Address - Country:US
Mailing Address - Phone:512-731-1395
Mailing Address - Fax:512-919-4149
Practice Address - Street 1:3000 POLAR LN STE 501
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3073
Practice Address - Country:US
Practice Address - Phone:512-731-1395
Practice Address - Fax:512-919-4149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-24
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3524936Medicaid