Organization
HTTPS://NPPES.CMS.HHS.GOV/IAWEB/LOGIN.DO
Active
Other names
https://nppes.cms.hhs.gov/IAWeb/login.do
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SONJA SHARYN COUSAR LPC (CEO/FOUNDER)
(512) 591-7305
Entity
Organization
Contact information
Practice address
703 S CHURCH ST BLDG 2, GEORGETOWN, TX 78626-5749
(512) 591-7305
Mailing address
703 S CHURCH ST BLDG 2, GEORGETOWN, TX 78626-5749
(254) 258-3769
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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