| Fulfilled Journey Counseling, Pllc | |
|
6750 Victoria Ave College Station TX 77845-8216 | |
| (936) 662-6125 | |
| Not Available |
| Full Name | Fulfilled Journey Counseling, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 6750 Victoria Ave, College Station, Texas |
| Authorized Official Name and Position | Shelly Coufal (OWNER/PROVIDER) |
| Authorized Official Contact | 9366626125 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fulfilled Journey Counseling, Pllc 6750 Victoria Ave College Station TX 77845-8216 Ph: (936) 662-6125 | Fulfilled Journey Counseling, Pllc 6750 Victoria Ave College Station TX 77845-8216 Ph: (936) 662-6125 |
| NPI Number | 1578156360 |
|---|---|
| Provider Enumeration Date | 02/12/2021 |
| Last Update Date | 02/12/2021 |
| Certification Date | 02/12/2021 |
| Medicare PECOS PAC ID | 2062857667 |
|---|---|
| Medicare Enrollment ID | O20240305000498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578156360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Shelly Jean Coufal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184212839 PECOS PAC ID: 3971948571 Enrollment ID: I20240305000680 |
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