MEDICARE: COUNSELING AND CONSULTING ASSOCIATES OF CENTRAL TEXAS

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	9836	TX
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	6993	TX
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	9805	TX
4	101YP2500X	Professional Counselor	18454	TX
5	101YP2500X	Professional Counselor	19676	TX

General Provider Information

NPI Number	:	1780791079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNSELING AND CONSULTING ASSOCIATES OF CENTRAL TEXAS

Provider Business Mailing Address
First Line	:	770 BOSQUE LN
Second Line	:
City	:	MC GREGOR
State	:	TX
Zip	:	76657-3401
Country	:	US
Telephone Number	:	254-405-1338
Fax Number	:	254-772-6118

Provider Business Practice Location Address
First Line	:	770 BOSQUE LN
Second Line	:
City	:	MC GREGOR
State	:	TX
Zip	:	76657-3401
Country	:	US
Telephone Number	:	254-405-1338
Fax Number	:	254-772-6118

Authorized Official
Title or Position	:	THERAPIST
Name	:	MS. MELODY D LIBBY
Credential	:	M. ED., LPC, LCDC
Telephone Number	:	254-405-1338

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	09/11/2025

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