Provider Demographics
NPI:1316570112
Name:CONSCIOUS HEALING COUNSELING
Entity Type:Organization
Organization Name:CONSCIOUS HEALING COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC, LCDC, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEFFANI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCDC
Authorized Official - Phone:713-408-1817
Mailing Address - Street 1:8504 CAPITOL VIEW DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78747-5400
Mailing Address - Country:US
Mailing Address - Phone:713-408-1817
Mailing Address - Fax:877-894-5104
Practice Address - Street 1:4422 PACK SADDLE PASS STE 106
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1644
Practice Address - Country:US
Practice Address - Phone:713-408-1817
Practice Address - Fax:877-894-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13451OtherLCDC LICENSE
TX76357OtherLPC LICENSE