Basic Information
| Provider Information | |||||||||
| NPI: | 1619467305 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLIANCE COUNSELING WORKS, LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2904 SANTA ROSITA DR | ||||||||
| Address2: | |||||||||
| City: | ROUND ROCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786653411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127512611 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2851 JOE DIMAGGIO BLVD STE 7 | ||||||||
| Address2: | |||||||||
| City: | ROUND ROCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786653928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127632186 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2018 | ||||||||
| LastUpdateDate: | 02/15/2022 | ||||||||
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| AuthorizedOfficialLastName: | MOUNTS | ||||||||
| AuthorizedOfficialFirstName: | BRANDY | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 5127632186 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | PHD, LPC | ||||||||
| NPICertificationDate: | 02/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | 76101 | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
ID Information
| ID | Type | State | Issuer | Description | 76101 | 01 | TX | TEXAS DEPARTMENT OF STATE HEALTH SERVICES | OTHER |