Provider Demographics
NPI:1609952274
Name:STABLE LIFE COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:STABLE LIFE COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:B
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW, LPC
Authorized Official - Phone:361-485-0899
Mailing Address - Street 1:3806 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-2638
Mailing Address - Country:US
Mailing Address - Phone:361-485-0899
Mailing Address - Fax:361-485-0817
Practice Address - Street 1:3806 N MAIN ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-2638
Practice Address - Country:US
Practice Address - Phone:361-485-0899
Practice Address - Fax:361-485-0817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty