Provider Demographics
NPI:1457725624
Name:PSYCHOLOGY CENTER OF AUSTIN, PLLC
Entity Type:Organization
Organization Name:PSYCHOLOGY CENTER OF AUSTIN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIESEMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-553-1563
Mailing Address - Street 1:4425 SOUTH MOPAC EXPRESSWAY
Mailing Address - Street 2:BLDG 3 STE 502
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735
Mailing Address - Country:US
Mailing Address - Phone:512-553-1563
Mailing Address - Fax:
Practice Address - Street 1:4425 S MOPAC EXPY
Practice Address - Street 2:BLDG. 3 STE. 502
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735
Practice Address - Country:US
Practice Address - Phone:512-553-1563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-25
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34831103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty