=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043015126
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LESTER COUNSELING TX
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2025
-----------------------------------------------------
Last Update Date | 02/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 304 N HARDING ST
-----------------------------------------------------
City | BRECKENRIDGE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76424-3219
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-551-2701
-----------------------------------------------------
Fax | 254-246-7963
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 304 N HARDING ST
-----------------------------------------------------
City | BRECKENRIDGE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76424-3219
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-551-2701
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/THERAPIST/SUPERVISOR
-----------------------------------------------------
Name | RHEA ANNE LESTER
-----------------------------------------------------
Credential | LPC-S
-----------------------------------------------------
Telephone | 979-551-2701
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------