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NPI Code Detail

MEDICARE: COURAGEOUS COUNSELING CENTER, PLLC

MEDICARE: COURAGEOUS COUNSELING CENTER, PLLC
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1093467227
Entity Type Code : Organization
Provider Name (Legal Business Name) : COURAGEOUS COUNSELING CENTER, PLLC
Provider Business Mailing Address
First Line : 3412 CUATRO VIENTOS DR
Second Line :
City : LAREDO
State : TX
Zip : 78046-6978
Country : US
Telephone Number : 959-707-3076
Fax Number :
Provider Business Practice Location Address
First Line : 6510 POLARIS DR STE 2
Second Line :
City : LAREDO
State : TX
Zip : 78041-2054
Country : US
Telephone Number : 956-707-3076
Fax Number :
Authorized Official
Title or Position : OWNER / PROVIDER
Name : MR. JONATHAN SERNA
Credential : LPC
Telephone Number : 956-413-1150
Provider Enumeration Date : 01/19/2022
Last Update Date : 01/19/2022

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Directions to “COURAGEOUS COUNSELING CENTER, PLLC ” Practice Location

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