MEDICARE: COURAGE 2 OVERCOME COUNSELING & CONSULTING 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

General Provider Information

NPI Number	:	1598468027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COURAGE 2 OVERCOME COUNSELING & CONSULTING SERVICES, PLLC

Provider Business Mailing Address
First Line	:	7703 N LAMAR BLVD STE 104
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78752-1003
Country	:	US
Telephone Number	:	512-931-1142
Fax Number	:

Provider Business Practice Location Address
First Line	:	7703 N LAMAR BLVD STE 104
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78752-1003
Country	:	US
Telephone Number	:	512-931-1142
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. ELENY A GUERRERO PENA
Credential	:	LPC
Telephone Number	:	512-931-1142

Provider Enumeration Date	:	03/23/2023
Last Update Date	:	09/04/2024

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