Healthcare Provider Details

I. General information

NPI: 1174299556
Provider Name (Legal Business Name): I.A.M. COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 08/17/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13423 BLANCO RD # 675
SAN ANTONIO TX
78216-2187
US

IV. Provider business mailing address

13423 BLANCO RD # 675
SAN ANTONIO TX
78216-2187
US

V. Phone/Fax

Practice location:
  • Phone: 210-564-7466
  • Fax: 210-492-0747
Mailing address:
  • Phone: 210-564-7466
  • Fax: 210-492-0747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CHERRELLE LATRICE BARTON
Title or Position: OWNER/CEO
Credential: LCSW
Phone: 210-683-1783