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General NPI Number Information
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NPI Number | 1669565529
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Entity Type | Organization
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Legal Business Name | NUEVA VIDA BEHAVIORAL HEALTH ASSOCIATES,INC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 9500 TIOGA DR STE A
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City | SAN ANTONIO
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State | TX
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Zip | 78230-3118
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Country | US
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Telephone | 210-616-0828
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Fax | 855-616-0829
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Provider Business Mailing Address
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Address Line | 5555 FREDERICKSBURG RD #102
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3500
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Country | US
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Telephone | 210-616-0828
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Fax | 210-616-0829
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Authorized Official
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Title or Position | CLINICAL DIRECTOR / OWNER
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Name | MS. ANDREA L ZUFLACHT
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Credential | LPC
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Telephone | 210-616-0828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 17496
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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