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General NPI Number Information
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NPI Number | 1487166997
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Entity Type | Organization
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Legal Business Name | STRAIT COUNSELING LLC
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 10/25/2017
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Provider Practice Location Address
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Address Line | 8008 SLIDE RD STE 24
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City | LUBBOCK
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State | TX
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Zip | 79424-2828
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Country | US
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Telephone | 806-340-0446
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6946
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City | LUBBOCK
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State | TX
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Zip | 79493-6946
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Country | US
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Telephone | 806-340-0446
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | SKYLAR M STRAIT
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Credential | M.ED., LPC
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Telephone | 806-340-0446
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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 | 73117
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License Number State | TX
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