Provider Demographics
NPI:1942451315
Name:ST. PJ'S COUNSELING CENTER
Entity Type:Organization
Organization Name:ST. PJ'S COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COUNSELING SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:OCHOA-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC-S
Authorized Official - Phone:210-533-1203
Mailing Address - Street 1:919 MISSION RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78210-4501
Mailing Address - Country:US
Mailing Address - Phone:210-533-1203
Mailing Address - Fax:210-531-0473
Practice Address - Street 1:919 MISSION RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78210-4501
Practice Address - Country:US
Practice Address - Phone:210-533-1203
Practice Address - Fax:210-531-0473
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. PETER ST. JOSEPH'S CHILDREN'S HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61620251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080101101Medicaid