Provider Demographics
NPI:1851942890
Name:WELLNESS WITH DR AUSTIN COUNSELING GROUP
Entity Type:Organization
Organization Name:WELLNESS WITH DR AUSTIN COUNSELING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAKALA
Authorized Official - Middle Name:M
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, PHD
Authorized Official - Phone:713-359-6423
Mailing Address - Street 1:1806 SAXON BEND TRL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-4762
Mailing Address - Country:US
Mailing Address - Phone:713-359-6423
Mailing Address - Fax:346-843-2947
Practice Address - Street 1:4800 SUGAR GROVE BLVD STE 607
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2150
Practice Address - Country:US
Practice Address - Phone:713-359-6423
Practice Address - Fax:346-843-2947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3941064Medicaid