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NPI Code Detail

MEDICARE: GENTLE HEART COUNSELING & SUPERVISION, PLLC

MEDICARE: GENTLE HEART COUNSELING & SUPERVISION, 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 : 1144853037
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENTLE HEART COUNSELING & SUPERVISION, PLLC
Provider Business Mailing Address
First Line : 514 CAMPANARIO LN
Second Line :
City : LAREDO
State : TX
Zip : 78043-5103
Country : US
Telephone Number : 956-744-2879
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 : 956-744-2879
Fax Number :
Authorized Official
Title or Position : PSYCHOTHERAPIST
Name : ARACELY CASTILLO HERNANDEZ
Credential : LPC-S, LCDC
Telephone Number : 956-744-2879
Provider Enumeration Date : 02/19/2020
Last Update Date : 02/19/2020

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Directions to “GENTLE HEART COUNSELING & SUPERVISION, PLLC ” Practice Location

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