Healthcare Provider Details

I. General information

NPI: 1609582709
Provider Name (Legal Business Name): SOUTH TEXAS COUNSELING & WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 E HONDO AVE
DEVINE TX
78016-3320
US

IV. Provider business mailing address

612 E HONDO AVE
DEVINE TX
78016-3320
US

V. Phone/Fax

Practice location:
  • Phone: 830-444-6281
  • Fax: 833-371-1451
Mailing address:
  • Phone: 830-444-6281
  • Fax: 833-371-1451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARY RIVERA
Title or Position: OWNER
Credential: LPC
Phone: 830-444-6281