Provider Demographics
NPI:1063011047
Name:CONCENTRIC COUNSELING AND COACHING, PLLC
Entity Type:Organization
Organization Name:CONCENTRIC COUNSELING AND COACHING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KREJCI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC-S
Authorized Official - Phone:210-816-1112
Mailing Address - Street 1:7113 SAN PEDRO AVE # 493
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6219
Mailing Address - Country:US
Mailing Address - Phone:210-812-1116
Mailing Address - Fax:
Practice Address - Street 1:7113 SAN PEDRO AVE # 493
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6219
Practice Address - Country:US
Practice Address - Phone:210-812-1116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty