Provider Demographics
NPI:1700981990
Name:HILL COUNTRY MENTAL HEALTH ASSOCIATES, LLC
Entity Type:Organization
Organization Name:HILL COUNTRY MENTAL HEALTH ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-554-1994
Mailing Address - Street 1:3532 BEE CAVES RD 101B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-554-1994
Mailing Address - Fax:512-292-9138
Practice Address - Street 1:3532 BEE CAVES RD 101B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-554-1994
Practice Address - Fax:512-292-9138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX325521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152399501Medicaid
TX152399502Medicaid
TX00932FMedicare ID - Type Unspecified