| It's Life Counseling And Wellness Pllc | |
|
85 Ne Loop 410 Ste 223 San Antonio TX 78216-5829 | |
| (210) 552-0985 | |
| Not Available |
| Full Name | It's Life Counseling And Wellness Pllc |
|---|---|
| Speciality | Counselor |
| Location | 85 Ne Loop 410 Ste 223, San Antonio, Texas |
| Authorized Official Name and Position | Casey Tully (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 2103803550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| It's Life Counseling And Wellness Pllc 85 Ne Loop 410 Ste 223 San Antonio TX 78216-5829 Ph: (210) 552-0985 | It's Life Counseling And Wellness Pllc 85 Ne Loop 410 Ste 223 San Antonio TX 78216-5829 Ph: (210) 552-0985 |
| NPI Number | 1578138236 |
|---|---|
| Provider Enumeration Date | 05/25/2021 |
| Last Update Date | 12/10/2023 |
| Certification Date | 12/10/2023 |
| Medicare PECOS PAC ID | 5991148801 |
|---|---|
| Medicare Enrollment ID | O20240522002418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578138236 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Casey J Tully |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174827455 PECOS PAC ID: 6305288317 Enrollment ID: I20240522002645 |
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