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General NPI Number Information
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NPI Number | 1144853037
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Entity Type | Organization
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Legal Business Name | GENTLE HEART COUNSELING & SUPERVISION, PLLC
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 6510 POLARIS DR STE 2
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City | LAREDO
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State | TX
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Zip | 78041-2054
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Country | US
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Telephone | 956-744-2879
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Fax |
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Provider Business Mailing Address
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Address Line | 514 CAMPANARIO LN
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City | LAREDO
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State | TX
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Zip | 78043-5103
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Country | US
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Telephone | 956-744-2879
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | ARACELY CASTILLO HERNANDEZ
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Credential | LPC-S, LCDC
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Telephone | 956-744-2879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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