Provider Demographics
NPI:1801261979
Name:VW COUNSELING & PERFORMANCE COACHING LLC
Entity type:Organization
Organization Name:VW COUNSELING & PERFORMANCE COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-870-6446
Mailing Address - Street 1:1405 CR 251
Mailing Address - Street 2:
Mailing Address - City:HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78861-6002
Mailing Address - Country:US
Mailing Address - Phone:210-870-6446
Mailing Address - Fax:210-598-1910
Practice Address - Street 1:11153 WESTWOOD LOOP
Practice Address - Street 2:STE 121
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-6776
Practice Address - Country:US
Practice Address - Phone:972-768-0754
Practice Address - Fax:210-598-1910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71366101YP2500X
TX70308101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX342330303Medicaid