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Organization

LAKELINE OUTPATIENT CARE PLLC

Active
Find providers by NPI
Organization

LAKELINE OUTPATIENT CARE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE CAMPBELL (DIRECTOR OF PATIENT ACCESS)
(512) 948-1752
Entity
Organization

Contact information

Practice address
1860 S LAKELINE BLVD, CEDAR PARK, TX 78613-3872
(512) 320-9003
Mailing address
1464 E WHITESTONE BLVD STE 1101, CEDAR PARK, TX 78613-9070
(512) 506-8503

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
NULL
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
NULL
175T00000X
Peer Specialist
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
NULL
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
NULL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—

Other

Enumeration date
04/10/2024
Last updated
10/04/2024
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