Provider Demographics
NPI:1689165995
Name:DAYBREAK COUNSELING PLLC
Entity Type:Organization
Organization Name:DAYBREAK COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-833-8615
Mailing Address - Street 1:700 N LBJ DR STE 112
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-4657
Mailing Address - Country:US
Mailing Address - Phone:512-576-4662
Mailing Address - Fax:210-598-0468
Practice Address - Street 1:261 MISTLETOE LN
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640
Practice Address - Country:US
Practice Address - Phone:512-576-4662
Practice Address - Fax:210-598-0468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63277101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty