MEDICARE: ROCK COUNSELING SERVICES 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	78117	TX

General Provider Information

NPI Number	:	1427561208
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCK COUNSELING SERVICES PLLC

Provider Business Mailing Address
First Line	:	601 QUAIL VALLEY DR
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-8051
Country	:	US
Telephone Number	:	512-318-7679
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 QUAIL VALLEY DR
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-8051
Country	:	US
Telephone Number	:	512-318-7679
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTI COPELAND
Credential	:	MA, LPC
Telephone Number	:	512-318-7679

Provider Enumeration Date	:	11/15/2017
Last Update Date	:	11/15/2017

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