Healthcare Provider Details

I. General information

NPI: 1548670821
Provider Name (Legal Business Name): DE SANTI COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2014
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E JACKSON ST STE 4
HARLINGEN TX
78550-6849
US

IV. Provider business mailing address

315 E JACKSON ST STE 4
HARLINGEN TX
78550-6849
US

V. Phone/Fax

Practice location:
  • Phone: 210-391-7221
  • Fax:
Mailing address:
  • Phone: 210-391-7221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number63944
License Number StateTX

VIII. Authorized Official

Name: MR. BENANCIO GONZALEZ JR.
Title or Position: OWNER - SOLE MEMBER
Credential: LPC
Phone: 210-391-7221