Provider Demographics
NPI:1346499852
Name:COUNSELING SERVICES OF AUSTIN, LLC
Entity Type:Organization
Organization Name:COUNSELING SERVICES OF AUSTIN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ASA
Authorized Official - Middle Name:ROGERS
Authorized Official - Last Name:SPHAR
Authorized Official - Suffix:III
Authorized Official - Credentials:PHD, LPC, LMFT
Authorized Official - Phone:512-524-9074
Mailing Address - Street 1:9901 BRODIE LN
Mailing Address - Street 2:SUITE 160-256
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5803
Mailing Address - Country:US
Mailing Address - Phone:512-869-9698
Mailing Address - Fax:
Practice Address - Street 1:2300 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-3246
Practice Address - Country:US
Practice Address - Phone:512-869-9698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62915101YP2500X
TX64181101YP2500X
TX201142106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty