Provider Demographics
NPI:1578069894
Name:HILL COUNTRY PLAY THERAPY CENTER
Entity Type:Organization
Organization Name:HILL COUNTRY PLAY THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GAROFANO BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC-S, RPT-S
Authorized Official - Phone:210-238-0545
Mailing Address - Street 1:819 WATER ST STE 106
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5343
Mailing Address - Country:US
Mailing Address - Phone:210-238-0545
Mailing Address - Fax:
Practice Address - Street 1:819 WATER ST STE 106
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5343
Practice Address - Country:US
Practice Address - Phone:210-238-0545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65889261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207941002Medicaid