Provider Demographics
NPI:1598976631
Name:GENTLE JOURNEYS COUNSELING
Entity Type:Organization
Organization Name:GENTLE JOURNEYS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:JOSEPHINE
Authorized Official - Last Name:ZANDER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:512-312-4412
Mailing Address - Street 1:214 SEQUOYAH ST
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-9208
Mailing Address - Country:US
Mailing Address - Phone:512-312-4412
Mailing Address - Fax:
Practice Address - Street 1:214 SEQUOYAH ST
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-9208
Practice Address - Country:US
Practice Address - Phone:512-312-4412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66542261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1053423483OtherNPI
IAIP547642Medicaid