Healthcare Provider Details

I. General information

NPI: 1073033494
Provider Name (Legal Business Name): AUSTIN PROFESSIONAL COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 06/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 DEEP EDDY AVE.
AUSTIN TX
78703
US

IV. Provider business mailing address

508 DEEP EDDY AVE.
AUSTIN TX
78703
US

V. Phone/Fax

Practice location:
  • Phone: 512-469-0535
  • Fax: 512-469-0889
Mailing address:
  • Phone: 512-469-0535
  • Fax: 512-469-6002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number69542
License Number StateTX

VIII. Authorized Official

Name: GEORGE F. HOWARD
Title or Position: OWNER/COUNSELOR
Credential: LPC
Phone: 512-469-0535