Provider Demographics
NPI:1093467227
Name:COURAGEOUS COUNSELING CENTER, PLLC
Entity Type:Organization
Organization Name:COURAGEOUS COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SERNA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:956-413-1150
Mailing Address - Street 1:3412 CUATRO VIENTOS DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-6978
Mailing Address - Country:US
Mailing Address - Phone:959-707-3076
Mailing Address - Fax:
Practice Address - Street 1:6510 POLARIS DR STE 2
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-2054
Practice Address - Country:US
Practice Address - Phone:956-707-3076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health