Provider Demographics
NPI:1376273029
Name:COSTA COUNSELING & CONSULTING, LLC
Entity Type:Organization
Organization Name:COSTA COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:361-510-9734
Mailing Address - Street 1:825 FM 799
Mailing Address - Street 2:
Mailing Address - City:GEORGE WEST
Mailing Address - State:TX
Mailing Address - Zip Code:78022
Mailing Address - Country:US
Mailing Address - Phone:361-510-9734
Mailing Address - Fax:
Practice Address - Street 1:825 FM 799
Practice Address - Street 2:
Practice Address - City:GEORGE WEST
Practice Address - State:TX
Practice Address - Zip Code:78022
Practice Address - Country:US
Practice Address - Phone:361-510-9734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty