MEDICARE: IN SERVICE OF THEE 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
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1215671961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN SERVICE OF THEE PLLC

Provider Business Mailing Address
First Line	:	1801 RED BUD LN STE B215
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-3813
Country	:	US
Telephone Number	:	413-862-9492
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 RED BUD LN STE B215
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-3813
Country	:	US
Telephone Number	:	413-862-9492
Fax Number	:	815-550-8746

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	NICHOLAS BONACCI
Credential	:
Telephone Number	:	512-521-4736

Provider Enumeration Date	:	04/27/2022
Last Update Date	:	10/22/2025

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Directions to “IN SERVICE OF THEE PLLC ” Practice Location

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