MEDICARE: TRAIN IN SYNC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	QMHP-CS, DSHS	TX
2	101YM0800X	Mental Health Counselor	19592346	TX

General Provider Information

NPI Number	:	1063791473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRAIN IN SYNC LLC

Provider Business Mailing Address
First Line	:	1213 RAMBLING TRL
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-4219
Country	:	US
Telephone Number	:	512-632-5665
Fax Number	:	512-401-3413

Provider Business Practice Location Address
First Line	:	1213 RAMBLING TRL
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-4219
Country	:	US
Telephone Number	:	512-632-5665
Fax Number	:	512-401-3413

Authorized Official
Title or Position	:	CEO/FOUNDER
Name	:	MS. JENNIFER MARIA PADRON
Credential	:	CPS, M.ED, QMHP-CS
Telephone Number	:	512-632-5665

Provider Enumeration Date	:	08/16/2011
Last Update Date	:	08/16/2011

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