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General NPI Number Information
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NPI Number | 1720529894
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Entity Type | Organization
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Legal Business Name | GABLE COUNSELING, LLC
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Dates
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Enumeration Date | 03/09/2017
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 825 W 11TH ST SUITE B
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City | AUSTIN
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State | TX
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Zip | 78701-2052
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Country | US
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Telephone | 512-256-6841
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Fax |
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Provider Business Mailing Address
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Address Line | 825 W 11TH ST SUITE B
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City | AUSTIN
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State | TX
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Zip | 78701-2052
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Country | US
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Telephone | 512-256-6841
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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 | JUSTIN JESSE GABLE
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Credential |
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Telephone | 817-301-9205
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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 | 74788
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License Number State | TX
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