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General NPI Number Information
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NPI Number | 1548547177
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Entity Type | Organization
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Legal Business Name | LONE STAR COUNSELING, LLC
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 102 E ALAMO ST SUITE 200 B
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City | BRENHAM
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State | TX
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Zip | 77833-3792
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Country | US
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Telephone | 979-830-8800
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Fax | 979-830-8800
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Provider Business Mailing Address
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Address Line | 6304 CARNATION LANE
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City | BLEIBLERVILLE
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State | TX
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Zip | 78931
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Country | US
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Telephone | 281-450-8786
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Fax | 979-830-8800
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MR. LEROY GONZALES
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Credential | LPC
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Telephone | 979-830-8800
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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 | 64543
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License Number State | TX
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