Provider Demographics
NPI:1982908299
Name:COUNSELINK, INC.
Entity Type:Organization
Organization Name:COUNSELINK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GENARO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDOVAL
Authorized Official - Suffix:
Authorized Official - Credentials:BA, LCDC, CART
Authorized Official - Phone:512-659-3518
Mailing Address - Street 1:4701 W GATE BLVD
Mailing Address - Street 2:STE. D-404
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1479
Mailing Address - Country:US
Mailing Address - Phone:512-659-3518
Mailing Address - Fax:512-899-8300
Practice Address - Street 1:4701 W GATE BLVD
Practice Address - Street 2:STE. D-404
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1479
Practice Address - Country:US
Practice Address - Phone:512-659-3518
Practice Address - Fax:512-899-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10685101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty