Provider Demographics
NPI:1659713659
Name:ALJON FAMILY COUNSELING PLLC
Entity Type:Organization
Organization Name:ALJON FAMILY COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:II
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-913-7445
Mailing Address - Street 1:4522 FREDERICKSBURG RD
Mailing Address - Street 2:SUITE A-45
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-6521
Mailing Address - Country:US
Mailing Address - Phone:210-716-5040
Mailing Address - Fax:866-716-3426
Practice Address - Street 1:4522 FREDERICKSBURG RD
Practice Address - Street 2:SUITE A-45
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-6521
Practice Address - Country:US
Practice Address - Phone:210-716-5040
Practice Address - Fax:866-716-3426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63494251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health