1033903133 NPI number — COUNSELING AND WELLNESS SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033903133 NPI number — COUNSELING AND WELLNESS SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNSELING AND WELLNESS SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033903133
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8526 NICHOLS STONE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOERNE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78015-5069
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-835-7566
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4207 GARDENDALE ST STE 100B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-3142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-570-8535
Provider Business Practice Location Address Fax Number:
210-749-7566
Provider Enumeration Date:
04/05/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GARZA-GONGORA
Authorized Official First Name:
ADRIANNA
Authorized Official Middle Name:
JUDITH
Authorized Official Title or Position:
LPC-S, OWNER
Authorized Official Telephone Number:
210-835-7566

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)