Provider Demographics
NPI:1619399466
Name:THE COUNSELING CENTER P.A.
Entity Type:Organization
Organization Name:THE COUNSELING CENTER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:OTSUJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-778-8195
Mailing Address - Street 1:1512 E GRIFFIN PKWY STE 8
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2416
Mailing Address - Country:US
Mailing Address - Phone:956-778-8195
Mailing Address - Fax:
Practice Address - Street 1:1512 E GRIFFIN PKWY STE 8
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2416
Practice Address - Country:US
Practice Address - Phone:956-778-8195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty