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General NPI Number Information
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NPI Number | 1346499852
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Entity Type | Organization
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Legal Business Name | COUNSELING SERVICES OF AUSTIN, LLC
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 2300 WILLIAMS DR
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City | GEORGETOWN
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State | TX
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Zip | 78628-3246
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Country | US
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Telephone | 512-869-9698
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Fax |
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Provider Business Mailing Address
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Address Line | 9901 BRODIE LN SUITE 160-256
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City | AUSTIN
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State | TX
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Zip | 78748-5803
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Country | US
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Telephone | 512-869-9698
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. ASA ROGERS SPHAR III
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Credential | PH.D., LPC, LMFT
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Telephone | 512-524-9074
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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 | 62915
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 201142
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 64181
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License Number State | TX
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