Provider Demographics
NPI:1639588676
Name:KUADRA CONSULTING LLC
Entity Type:Organization
Organization Name:KUADRA CONSULTING LLC
Other - Org Name:KUADRA CONSULTING AND COUNSELING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KHADIJAT
Authorized Official - Middle Name:
Authorized Official - Last Name:QUADRI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-314-7687
Mailing Address - Street 1:4100 E PIEDRAS DR
Mailing Address - Street 2:SUITE 262
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1401
Mailing Address - Country:US
Mailing Address - Phone:210-314-7687
Mailing Address - Fax:210-314-7494
Practice Address - Street 1:4100 E PIEDRAS DR
Practice Address - Street 2:SUITE 262
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1401
Practice Address - Country:US
Practice Address - Phone:210-314-7687
Practice Address - Fax:210-314-7494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67102101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX332994801Medicaid