Provider Demographics
NPI:1417766643
Name:OPEN SPACE COUNSELING, LLC
Entity type:Organization
Organization Name:OPEN SPACE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:AULT- HAYSLIP
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:512-507-0342
Mailing Address - Street 1:7301 N RANCH ROAD 620 STE 155-393
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-4539
Mailing Address - Country:US
Mailing Address - Phone:512-507-0342
Mailing Address - Fax:
Practice Address - Street 1:7301 N RANCH ROAD 620 STE 155-393
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-4539
Practice Address - Country:US
Practice Address - Phone:512-507-0342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty