Provider Demographics
NPI:1285406900
Name:LIVE AUTHENTICALLY COUNSELING
Entity type:Organization
Organization Name:LIVE AUTHENTICALLY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CATLETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-200-4247
Mailing Address - Street 1:200 UNIVERSITY BLVD STE 225-252
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1001
Mailing Address - Country:US
Mailing Address - Phone:512-200-4247
Mailing Address - Fax:
Practice Address - Street 1:200 UNIVERSITY BLVD STE 225-252V
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-1001
Practice Address - Country:US
Practice Address - Phone:512-200-4247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty