Provider Demographics
NPI:1194492983
Name:RESET SPACE COUNSELING SOLUTIONS, PLLC
Entity type:Organization
Organization Name:RESET SPACE COUNSELING SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FEBE
Authorized Official - Middle Name:SARAI
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:512-537-4065
Mailing Address - Street 1:PO BOX 34477
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78265-4477
Mailing Address - Country:US
Mailing Address - Phone:512-537-4065
Mailing Address - Fax:512-539-2881
Practice Address - Street 1:12702 TOEPPERWEIN RD STE 215
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3250
Practice Address - Country:US
Practice Address - Phone:512-537-4065
Practice Address - Fax:512-539-2881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-27
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1194240192OtherNPI 1
TX412180801Medicaid