Provider Demographics
NPI:1457561276
Name:AUSTIN PSYCHOLOGY & ASSESSMENT CENTER
Entity Type:Organization
Organization Name:AUSTIN PSYCHOLOGY & ASSESSMENT CENTER
Other - Org Name:APACENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LSSP
Authorized Official - Phone:512-891-1500
Mailing Address - Street 1:6012 W WILLIAM CANNON DR
Mailing Address - Street 2:B-103
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-1980
Mailing Address - Country:US
Mailing Address - Phone:512-891-1500
Mailing Address - Fax:512-857-7679
Practice Address - Street 1:6012 W WILLIAM CANNON DR
Practice Address - Street 2:B-103
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1980
Practice Address - Country:US
Practice Address - Phone:512-891-1500
Practice Address - Fax:512-857-7679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty