Provider Demographics
NPI:1790218337
Name:STOVER COUNSELING, PLLC
Entity Type:Organization
Organization Name:STOVER COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MALLORY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:STOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:512-964-4663
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:COUPLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78615-0325
Mailing Address - Country:US
Mailing Address - Phone:512-964-4663
Mailing Address - Fax:
Practice Address - Street 1:1618 WILLIAMS DR
Practice Address - Street 2:SUITE 3
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-3678
Practice Address - Country:US
Practice Address - Phone:512-964-4663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73618101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty