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General NPI Number Information
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NPI Number | 1871056218
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Entity Type | Organization
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Legal Business Name | REAL TALK COUNSELING LLC
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 5121 CRESTWAY DRIVE SUITE 109
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City | SAN ANTONIO
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State | TX
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Zip | 78239
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Country | US
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Telephone | 210-600-4407
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Fax | 210-600-4407
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Provider Business Mailing Address
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Address Line | 5121 CRESTWAY DRIVE SUITE 109
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City | SAN ANTONIO
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State | TX
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Zip | 78239
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Country | US
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Telephone | 210-600-4407
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Fax | 210-600-4407
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MS. MICHELLE RENEE ROWLAND
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Credential |
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Telephone | 210-600-4407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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