Provider Demographics
NPI:1669765707
Name:HEALING TREE COUNSELING
Entity type:Organization
Organization Name:HEALING TREE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:SILVA
Authorized Official - Last Name:SEGURA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LPC
Authorized Official - Phone:512-636-5881
Mailing Address - Street 1:2525 WALLINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6900
Mailing Address - Country:US
Mailing Address - Phone:512-636-5881
Mailing Address - Fax:
Practice Address - Street 1:2808 MECCA RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78733-1033
Practice Address - Country:US
Practice Address - Phone:512-636-5881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201216106H00000X
TX64585101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty