Provider Demographics
NPI:1518721794
Name:USSAMA TAHA COUNSELING PLLC
Entity Type:Organization
Organization Name:USSAMA TAHA COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:USSAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-256-0619
Mailing Address - Street 1:5900 BALCONES DR # 16741
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4257
Mailing Address - Country:US
Mailing Address - Phone:512-256-0619
Mailing Address - Fax:
Practice Address - Street 1:8700 MENCHACA RD STE 806
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5379
Practice Address - Country:US
Practice Address - Phone:512-256-0619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health