Provider Demographics
NPI:1144853037
Name:GENTLE HEART COUNSELING & SUPERVISION, PLLC
Entity type:Organization
Organization Name:GENTLE HEART COUNSELING & SUPERVISION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ARACELY
Authorized Official - Middle Name:CASTILLO
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, LCDC
Authorized Official - Phone:956-744-2879
Mailing Address - Street 1:514 CAMPANARIO LN
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-5103
Mailing Address - Country:US
Mailing Address - Phone:956-744-2879
Mailing Address - Fax:
Practice Address - Street 1:6510 POLARIS DR STE 2
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-2054
Practice Address - Country:US
Practice Address - Phone:956-744-2879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health