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Organization
KELLY MANUEL BASTROP COUNSELING, PLLC
Active
Organization
KELLY MANUEL BASTROP COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY A MANUEL LCSW, LCDC (GOVERNING AUTHORITY)
(512) 985-7104
Entity
Organization
Contact information
Practice address
111 N HASLER BLVD STE 219, BASTROP, TX 78602-3984
(512) 985-7104
Mailing address
157 LISA LN UNIT B, BASTROP, TX 78602-5782
(512) 985-7104
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/05/2022
Last updated
01/08/2022
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