| Pedersen Counseling Pllc | |
|
317 Copperleaf Rd Lakeway TX 78734-4246 | |
| (512) 963-3660 | |
| Not Available |
| Full Name | Pedersen Counseling Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 317 Copperleaf Rd, Lakeway, Texas |
| Authorized Official Name and Position | Kelly L Pedersen (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 5129633660 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pedersen Counseling Pllc 317 Copperleaf Rd Lakeway TX 78734-4246 Ph: (512) 963-3660 | Pedersen Counseling Pllc 317 Copperleaf Rd Lakeway TX 78734-4246 Ph: (512) 963-3660 |
| NPI Number | 1104556364 |
|---|---|
| Provider Enumeration Date | 06/12/2022 |
| Last Update Date | 06/12/2022 |
| Certification Date | 06/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104556364 | NPI | - | NPPES |
| 1497872493 | Other | TX | MY NPI TYPE 1 NUMBER - SOLE PRORIETOR |
| 101YP2500X | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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