Provider Demographics
NPI:1427658954
Name:BEYOND THE ROOT COUNSELING AND CONSULTING,PLLC
Entity type:Organization
Organization Name:BEYOND THE ROOT COUNSELING AND CONSULTING,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAWANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:210-704-7460
Mailing Address - Street 1:18018 OVERLOOK LOOP
Mailing Address - Street 2:STE 105 #243
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259
Mailing Address - Country:US
Mailing Address - Phone:210-704-7460
Mailing Address - Fax:210-783-1054
Practice Address - Street 1:24028 GAVARRA
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78261-2971
Practice Address - Country:US
Practice Address - Phone:210-937-1049
Practice Address - Fax:210-783-1054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty