1558633974 NPI number — SWOBODA COUNSELING SERVICES, INC.

Table of content: DIANE ELIZABETH WEIBELER APN (NPI 1841769445)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558633974 NPI number — SWOBODA COUNSELING SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SWOBODA COUNSELING 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:
1558633974
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4606 CENTERVIEW
Provider Second Line Business Mailing Address:
SUITE 266
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78228-1214
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-355-8840
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4606 CENTERVIEW
Provider Second Line Business Practice Location Address:
SUITE 266
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78228-1214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-355-8840
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/31/2012

Additional Information

Authorized Official

Authorized Official Last Name:
SWOBODA
Authorized Official First Name:
NATHAN
Authorized Official Middle Name:
ERIC
Authorized Official Title or Position:
OWNER/PROFESSIONAL COUNSELOR
Authorized Official Telephone Number:
210-355-8840

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  60248 , 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)





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