Provider Demographics
NPI:1881179315
Name:SUSAN GONZALES COUNSELING, PLLC
Entity Type:Organization
Organization Name:SUSAN GONZALES COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PROFESSIONAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:JARROD
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-264-1337
Mailing Address - Street 1:5000 BEE CAVES RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5254
Mailing Address - Country:US
Mailing Address - Phone:512-593-5032
Mailing Address - Fax:
Practice Address - Street 1:5000 BEE CAVES RD STE 100
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5254
Practice Address - Country:US
Practice Address - Phone:512-593-5032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty