=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275671836
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FAYE ACOCKS HALLFORD LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/02/2007
-----------------------------------------------------
Last Update Date | 09/26/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10615 PERRIN BEITEL RD STE 406
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78217-3141
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-946-2273
-----------------------------------------------------
Fax | 210-637-1756
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10615 PERRIN BEITEL #406
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-946-2273
-----------------------------------------------------
Fax | 210-637-1756
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 08668
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------