Provider Demographics
NPI:1437491560
Name:AUSTIN RESTORATIVE THERAPIES, PLLC
Entity Type:Organization
Organization Name:AUSTIN RESTORATIVE THERAPIES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LONGORIA-CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMFTA
Authorized Official - Phone:512-537-3093
Mailing Address - Street 1:6448 E HWY 290
Mailing Address - Street 2:BLDG. E SUITE 114
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1068
Mailing Address - Country:US
Mailing Address - Phone:512-520-9384
Mailing Address - Fax:267-867-3811
Practice Address - Street 1:6448 E HWY 290
Practice Address - Street 2:BLDG. E SUITE 114
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1068
Practice Address - Country:US
Practice Address - Phone:512-520-9384
Practice Address - Fax:267-867-3811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty