Provider Demographics
NPI:1215052337
Name:SOUTH TEXAS COUNSELING AND FAMILY SERVICE CENTER
Entity type:Organization
Organization Name:SOUTH TEXAS COUNSELING AND FAMILY SERVICE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC-I
Authorized Official - Phone:210-382-0059
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:DEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:78016-0278
Mailing Address - Country:US
Mailing Address - Phone:210-382-0059
Mailing Address - Fax:830-663-5960
Practice Address - Street 1:1455 COUNTY ROAD 773
Practice Address - Street 2:
Practice Address - City:DEVINE
Practice Address - State:TX
Practice Address - Zip Code:78016-4584
Practice Address - Country:US
Practice Address - Phone:210-382-0059
Practice Address - Fax:830-663-5960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62805101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty