| Kelly Manuel Bastrop Counseling, Pllc | |
|
111 N Hasler Blvd Ste 219 Bastrop TX 78602-3984 | |
| (512) 985-7104 | |
| Not Available |
| Full Name | Kelly Manuel Bastrop Counseling, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 111 N Hasler Blvd Ste 219, Bastrop, Texas |
| Authorized Official Name and Position | Kelly A Manuel (GOVERNING AUTHORITY) |
| Authorized Official Contact | 5129857104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Manuel Bastrop Counseling, Pllc 157 Lisa Ln Unit B Bastrop TX 78602-5782 Ph: (512) 985-7104 | Kelly Manuel Bastrop Counseling, Pllc 111 N Hasler Blvd Ste 219 Bastrop TX 78602-3984 Ph: (512) 985-7104 |
| NPI Number | 1033870662 |
|---|---|
| Provider Enumeration Date | 01/05/2022 |
| Last Update Date | 01/08/2022 |
| Certification Date | 01/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033870662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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