Provider Demographics
NPI: | 1790452852 |
---|---|
Name: | RS&D COUNSELING AND CONSULTING, PLLC |
Entity Type: | Organization |
Organization Name: | RS&D COUNSELING AND CONSULTING, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CLINICAL SOCIAL WORKER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SHANETRA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FOWLER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LCSW, LSOTP |
Authorized Official - Phone: | 773-633-7365 |
Mailing Address - Street 1: | 5900 BALCONES DR STE 100 |
Mailing Address - Street 2: | |
Mailing Address - City: | AUSTIN |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78731-4298 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 737-333-5283 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 5900 BALCONES DR STE 100 |
Practice Address - Street 2: | |
Practice Address - City: | AUSTIN |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78731-4298 |
Practice Address - Country: | US |
Practice Address - Phone: | 737-333-5283 |
Practice Address - Fax: | 512-229-9125 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-08-26 |
Last Update Date: | 2021-08-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Single Specialty |