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Organization
AUSTIN TRAVIS COUNTY MHMR CENTER
Active
Organization
AUSTIN TRAVIS COUNTY MHMR CENTER
Active
Other names
ATCMHMR MR Service Coordination
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES RUSSEL VAN NORMAN M.D. (MEDICAL DIRECTOR)
(512) 440-4021
Entity
Organization
Contact information
Practice address
5225 N LAMAR BLVD, AUSTIN, TX 78751-1820
(512) 483-5800
(512) 483-5800
Mailing address
PO BOX 3548, AUSTIN, TX 78764-3548
(512) 445-7787
(512) 440-4059
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
NULL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
NULL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1335424-01
—
TX
Enumeration date
02/27/2007
Last updated
09/21/2011
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