Provider Demographics
NPI:1619161759
Name:CHILD TRAUMA RELIEF CONSULTANTS
Entity Type:Organization
Organization Name:CHILD TRAUMA RELIEF CONSULTANTS
Other - Org Name:CHILD TRAUMA CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR CER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC CTS
Authorized Official - Phone:210-223-9369
Mailing Address - Street 1:343 W HOUSTON ST
Mailing Address - Street 2:STE #902
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205
Mailing Address - Country:US
Mailing Address - Phone:210-223-9369
Mailing Address - Fax:210-223-9369
Practice Address - Street 1:343 W HOUSTON ST
Practice Address - Street 2:STE #902
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205
Practice Address - Country:US
Practice Address - Phone:210-223-9369
Practice Address - Fax:210-223-9369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty