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General NPI Number Information
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NPI Number | 1073030052
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Entity Type | Organization
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Legal Business Name | COMFORT HARBOR COUNSELING & WELLNESS CENTER
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Dates
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Enumeration Date | 08/29/2017
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Last Update Date | 08/29/2017
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Provider Practice Location Address
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Address Line | 100 W HOSACK ST STE 104
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City | BOERNE
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State | TX
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Zip | 78006-2644
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Country | US
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Telephone | 210-421-5639
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Fax | 888-486-1392
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Provider Business Mailing Address
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Address Line | 1815 CYPRESS PASS RD
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City | SPRING BRANCH
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State | TX
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Zip | 78070-5508
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Country | US
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Telephone | 210-421-5639
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Fax | 888-486-1392
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Authorized Official
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Title or Position | DIRECTOR
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Name | MICHAEL HAWKINS
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Credential |
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Telephone | 210-421-5639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19907
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 60283
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License Number State | TX
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