Healthcare Provider Details

I. General information

NPI: 1689165995
Provider Name (Legal Business Name): DAYBREAK COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 06/15/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 MISTLETOE LN
KYLE TX
78640
US

IV. Provider business mailing address

261 MISTLETOE LN
KYLE TX
78640-5546
US

V. Phone/Fax

Practice location:
  • Phone: 512-576-4662
  • Fax: 210-598-0468
Mailing address:
  • Phone: 512-693-7734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number63277
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ERIN MENDOZA
Title or Position: OWNER
Credential:
Phone: 512-693-7734