Organization
COUNSELING AT TERAVISTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARRON CLARK LPC (OWNER/COUNSELOR)
(512) 642-5230
Entity
Organization
Contact information
Practice address
4000 SUNRISE RD STE 3220, ROUND ROCK, TX 78665-1239
(512) 642-5230
Mailing address
2209 STIRRUP DR, ROUND ROCK, TX 78681-7355
(806) 440-6584
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
72397
TX
Other
Enumeration date
09/15/2017
Last updated
09/15/2017
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