Provider Demographics
NPI:1831859263
Name:TEXAS TAPROOT COUNSELING PLLC
Entity type:Organization
Organization Name:TEXAS TAPROOT COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:KRISTIN
Authorized Official - Last Name:LOZO
Authorized Official - Suffix:
Authorized Official - Credentials:NCC, LPC, RPT
Authorized Official - Phone:512-808-0268
Mailing Address - Street 1:10900 RESEARCH BLVD STE 160C PMB 12
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-808-0268
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DR. SUITE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731
Practice Address - Country:US
Practice Address - Phone:512-808-0268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-27
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health