Provider Demographics
NPI:1780219345
Name:SGM COUNSELING PLLC
Entity type:Organization
Organization Name:SGM COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:GAUNTT
Authorized Official - Last Name:MOELLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:512-720-9956
Mailing Address - Street 1:604 W 35TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1207
Mailing Address - Country:US
Mailing Address - Phone:512-720-9956
Mailing Address - Fax:
Practice Address - Street 1:604 W 35TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1207
Practice Address - Country:US
Practice Address - Phone:512-720-9956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty