Deep Eddy Psychotherapy Management, LLC
NPI 1457740862ActiveOrganization· Psychologist, Counseling· Austin, TX
Psychologist, Counseling in Austin, Texas, registered in NPPES in January 2015. The authorized official on file is Glenn R. Olds, PH.D., Managing Psychologist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1457740862 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 22, 2015 |
| Last updated in NPPES | Dec 27, 2022 |
| Certified by provider | Dec 27, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Counseling Primary | 103TC1900X | 34890 | TX |
| Psychologist, Clinical | 103TC0700X | 21274 | TX |
| Psychologist, Counseling | 103TC1900X | 34301 | TX |
| Psychologist, Counseling | 103TC1900X | 20938 | TX |
| Psychologist, Counseling | 103TC1900X | 33076 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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