Provider Demographics
NPI:1922377761
Name:AN ESTEEMED YOU COUNSELING SERVICE
Entity Type:Organization
Organization Name:AN ESTEEMED YOU COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARRON
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BRASHER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-259-7671
Mailing Address - Street 1:17460 IH 35 NORTH
Mailing Address - Street 2:STE 160 PMB 149
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-1243
Mailing Address - Country:US
Mailing Address - Phone:210-259-7671
Mailing Address - Fax:210-592-8714
Practice Address - Street 1:234 E AVIATION BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSAL CITY
Practice Address - State:TX
Practice Address - Zip Code:78148-4404
Practice Address - Country:US
Practice Address - Phone:210-259-7671
Practice Address - Fax:210-592-8714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63628251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207391801Medicaid