1609969815 NPI number — COUNSELING & CARE, PC

Table of content: (NPI 1609969815)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609969815 NPI number — COUNSELING & CARE, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNSELING & CARE, PC
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:
1609969815
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3025 QUAIL SPRINGS RD APT D3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78414-3706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-215-5877
Provider Business Mailing Address Fax Number:
800-745-2060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5151 FLYNN PKWY STE 412B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78411-4367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-215-5877
Provider Business Practice Location Address Fax Number:
800-745-2060
Provider Enumeration Date:
10/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MATOSKY
Authorized Official First Name:
JANICE
Authorized Official Middle Name:
H.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
361-215-5877

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  16780 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1731283-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3747773 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 84587L . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 493233 . This is a "VALUE OPTIONS AND TRICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 263724 . This is a "COMPSYCH" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5678237 . This is a "FIRST HEALTH" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 10013368 . This is a "AMERIGROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 369025 . This is a "MHN AND MHN TRICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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