Healthcare Provider Details

I. General information

NPI: 1063791473
Provider Name (Legal Business Name): TRAIN IN SYNC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 08/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 RAMBLING TRL
CEDAR PARK TX
78613-4219
US

IV. Provider business mailing address

1213 RAMBLING TRL
CEDAR PARK TX
78613-4219
US

V. Phone/Fax

Practice location:
  • Phone: 512-632-5665
  • Fax: 512-401-3413
Mailing address:
  • Phone: 512-632-5665
  • Fax: 512-401-3413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number19592346
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberQMHP-CS, DSHS
License Number StateTX

VIII. Authorized Official

Name: MS. JENNIFER MARIA PADRON
Title or Position: CEO/FOUNDER
Credential: CPS, M.ED, QMHP-CS
Phone: 512-632-5665