=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659935625
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RELATIONAL COUNSELING SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2019
-----------------------------------------------------
Last Update Date | 04/25/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 141 LOOKOUT RD
-----------------------------------------------------
City | HUTTO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78634-5402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-693-7254
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 141 LOOKOUT RD
-----------------------------------------------------
City | HUTTO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78634-5402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-693-7254
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. PAUL J IARUSSI
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 512-693-7254
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------