Organization
CONCEIVABLE RESOLUTIONS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH EDWARD GOODRUM LPC, LCDC, CART (LPC)
(210) 288-1835
Entity
Organization
Contact information
Practice address
212 CHESTNUT ST STE 2, SAN ANTONIO, TX 78202-2720
(210) 288-1835
(210) 932-9891
Mailing address
212 CHESTNUT ST STE 2, SAN ANTONIO, TX 78202-2720
(210) 288-1835
(210) 932-9891
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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