Provider Demographics
NPI:1528852738
Name:AHUMADA, NICKI MERCEDES (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:NICKI
Middle Name:MERCEDES
Last Name:AHUMADA
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 EDMUNDSBURY DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78747-3999
Mailing Address - Country:US
Mailing Address - Phone:620-339-1231
Mailing Address - Fax:
Practice Address - Street 1:1714 FORTVIEW RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7671
Practice Address - Country:US
Practice Address - Phone:620-339-1231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96552101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional