Provider Demographics
NPI: | 1003349077 |
---|---|
Name: | JUNO COUNSELING PLLC |
Entity Type: | Organization |
Organization Name: | JUNO COUNSELING PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGING PARTNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SALLY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | RUMSEY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 512-645-9388 |
Mailing Address - Street 1: | 13625 POND SPRINGS RD |
Mailing Address - Street 2: | SUITE 104 |
Mailing Address - City: | AUSTIN |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78729-4427 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 13625 POND SPRINGS RD |
Practice Address - Street 2: | SUITE 104 |
Practice Address - City: | AUSTIN |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78729-4427 |
Practice Address - Country: | US |
Practice Address - Phone: | 512-645-9388 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-04-06 |
Last Update Date: | 2017-04-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 63417 | 101YP2500X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Single Specialty |