Provider Demographics
NPI:1700207552
Name:HEART SONG CHRISTIAN COUNSELING, PLLC
Entity Type:Organization
Organization Name:HEART SONG CHRISTIAN COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:QUILLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-446-8108
Mailing Address - Street 1:19115 FM 2252
Mailing Address - Street 2:SUITE 12
Mailing Address - City:GARDEN RIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:78266-2577
Mailing Address - Country:US
Mailing Address - Phone:210-446-8108
Mailing Address - Fax:
Practice Address - Street 1:19115 FM 2252
Practice Address - Street 2:SUITE 12
Practice Address - City:GARDEN RIDGE
Practice Address - State:TX
Practice Address - Zip Code:78266-2577
Practice Address - Country:US
Practice Address - Phone:210-446-8108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67033251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health