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General NPI Number Information
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NPI Number | 1457070450
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Entity Type | Organization
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Legal Business Name | LIFEPROOF COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 6326 SOVEREIGN ST STE 238
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City | SAN ANTONIO
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State | TX
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Zip | 78229-5130
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Country | US
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Telephone | 726-336-9390
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Fax | 726-336-9311
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Provider Business Mailing Address
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Address Line | 14223 N HILLS VILLAGE DR
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City | SAN ANTONIO
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State | TX
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Zip | 78249-2564
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Country | US
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Telephone | 210-850-1157
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | KANDACE SANCHEZ
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Credential | MA, LPC, LCDC
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Telephone | 210-850-1157
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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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