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General NPI Number Information
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NPI Number | 1588807986
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Entity Type | Organization
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Legal Business Name | COUNSELING SPECIALTY GROUP
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 04/21/2009
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Provider Practice Location Address
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Address Line | 444 EXECUTIVE CENTER BLVD SUITE 210
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City | EL PASO
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State | TX
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Zip | 79902-1058
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Country | US
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Telephone | 915-633-2071
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Fax | 915-532-1898
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Provider Business Mailing Address
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Address Line | 444 EXECUTIVE CENTER BLVD SUITE 210
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City | EL PASO
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State | TX
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Zip | 79902-1058
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Country | US
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Telephone | 915-633-2071
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Fax | 915-532-1898
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MS. GEORGINA ESPINOZA
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Credential | M.ED., L.P.C.
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Telephone | 915-633-2071
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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 | 19476
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License Number State | TX
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