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General NPI Number Information
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NPI Number | 1235395229
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Entity Type | Organization
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Legal Business Name | GEORGETOWN COUNSELING SERVICES
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 624 S AUSTIN AVE STE 220
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City | GEORGETOWN
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State | TX
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Zip | 78626-5707
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Country | US
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Telephone | 512-869-1152
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Fax | 512-869-1145
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Provider Business Mailing Address
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Address Line | 624 S AUSTIN AVE STE 220
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City | GEORGETOWN
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State | TX
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Zip | 78626-5707
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Country | US
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Telephone | 512-869-1152
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Fax | 512-869-1145
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. SANDRA R. JOHNSON
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Credential |
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Telephone | 512-773-6402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 4265
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License Number State | TX
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