Provider Demographics
NPI:1952614158
Name:WHOLE LIFE COUNSELING AND RESOURCE CENTER OF TEXAS
Entity Type:Organization
Organization Name:WHOLE LIFE COUNSELING AND RESOURCE CENTER OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COUNSELING
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-857-7860
Mailing Address - Street 1:8590 CRESTWAY DR
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-3425
Mailing Address - Country:US
Mailing Address - Phone:210-661-3030
Mailing Address - Fax:210-310-0818
Practice Address - Street 1:8590 CRESTWAY DR
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-3425
Practice Address - Country:US
Practice Address - Phone:210-661-3030
Practice Address - Fax:210-310-0818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19115101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty