MEDICARE: PRESTIGE GUIDANCE COUNSELING, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720562887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESTIGE GUIDANCE COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	6864 COLUMBIA RIDGE DR
Second Line	:
City	:	CONVERSE
State	:	TX
Zip	:	78109-3419
Country	:	US
Telephone Number	:	210-954-1238
Fax Number	:

Provider Business Practice Location Address
First Line	:	6864 COLUMBIA RIDGE DR
Second Line	:
City	:	CONVERSE
State	:	TX
Zip	:	78109-3419
Country	:	US
Telephone Number	:	210-954-1238
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. JAMAICA D BATES
Credential	:	LPC
Telephone Number	:	210-954-1238

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	04/15/2026

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