Provider Demographics
NPI:1477216745
Name:ENCARNACION, ABSERET
Entity Type:Individual
Prefix:MRS
First Name:ABSERET
Middle Name:
Last Name:ENCARNACION
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ABSERET
Other - Middle Name:JOHANAS
Other - Last Name:ENCARNACION
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4646 MUELLER BLVD APT 2001
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3391
Mailing Address - Country:US
Mailing Address - Phone:917-531-1684
Mailing Address - Fax:
Practice Address - Street 1:2717 RIO GRANDE ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-4018
Practice Address - Country:US
Practice Address - Phone:512-669-5701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional