Provider Demographics
NPI:1073736864
Name:HILLSIDE COUNSELING LLC
Entity Type:Organization
Organization Name:HILLSIDE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:817-694-0722
Mailing Address - Street 1:106 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:WILLOW PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76087-8886
Mailing Address - Country:US
Mailing Address - Phone:817-694-0722
Mailing Address - Fax:
Practice Address - Street 1:112 SW THOMAS ST
Practice Address - Street 2:SUITE 104
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-3818
Practice Address - Country:US
Practice Address - Phone:817-694-0722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65286101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty