Provider Demographics
NPI:1225677479
Name:VASSARRIS COUNSELING
Entity Type:Organization
Organization Name:VASSARRIS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:VASSELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:210-598-0040
Mailing Address - Street 1:PO BOX 202
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-0202
Mailing Address - Country:US
Mailing Address - Phone:210-598-0040
Mailing Address - Fax:
Practice Address - Street 1:700 W FM 78 STE 201
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-3553
Practice Address - Country:US
Practice Address - Phone:210-598-0040
Practice Address - Fax:210-598-0102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-04
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty