MEDICARE: JOSEPH DAVID ACOSTA MA LIC PROF COUNSELO

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	16839	TX

General Provider Information

NPI Number	:	1851490940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH DAVID ACOSTA MA LIC PROF COUNSELO

Provider Business Mailing Address
First Line	:	4131 SPICEWOOD SPRINGS
Second Line	:	SUITE N5
City	:	AUSTIN
State	:	TX
Zip	:	78759-8852
Country	:	US
Telephone Number	:	512-576-9523
Fax Number	:

Provider Business Practice Location Address
First Line	:	4131 SPICEWOOD SPRINGS
Second Line	:	SUITE N5
City	:	AUSTIN
State	:	TX
Zip	:	78759-8852
Country	:	US
Telephone Number	:	512-576-9523
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/08/2007

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