Healthcare Provider Details

I. General information

NPI: 1386465763
Provider Name (Legal Business Name): ROBERT TRUJILLO COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 10/18/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151073 ESCALANTE PASS
VON ORMY TX
78073
US

IV. Provider business mailing address

151073 ESCALANTE PASS
VON ORMY TX
78073
US

V. Phone/Fax

Practice location:
  • Phone: 210-990-6942
  • Fax: 210-903-0750
Mailing address:
  • Phone: 210-990-6942
  • Fax: 210-903-0750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ROBERT ANTHONY TRUJILLO
Title or Position: THERAPIST/OWNER
Credential: LPC
Phone: 210-990-6942