=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730880923
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SL COUNSELING SERVICES PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2023
-----------------------------------------------------
Last Update Date | 03/14/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6006 N MESA ST STE 803
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79912-4655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-995-8800
-----------------------------------------------------
Fax | 915-995-8878
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6006 N MESA ST STE 803
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79912-4655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-995-8800
-----------------------------------------------------
Fax | 915-995-8878
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/LPC
-----------------------------------------------------
Name | STEPHANIE LAIZE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 915-995-8800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------