Provider Demographics
NPI:1306869979
Name:AUSTIN, WILLIAM G (PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:G
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 883009
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80488-3009
Mailing Address - Country:US
Mailing Address - Phone:970-871-4527
Mailing Address - Fax:970-871-6336
Practice Address - Street 1:405 S. LINCOLN AVENUE
Practice Address - Street 2:SUITE C
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-0000
Practice Address - Country:US
Practice Address - Phone:970-871-4527
Practice Address - Fax:970-871-6336
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2021103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO00209341Medicaid
CO00209341Medicaid