Provider Demographics
NPI:1780474270
Name:EQUINOX COUNSELING SOLUTIONS PLLC
Entity type:Organization
Organization Name:EQUINOX COUNSELING SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAFRADE-BLUME
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, BCD
Authorized Official - Phone:210-201-2649
Mailing Address - Street 1:355 B ST W STE 198
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78150-4520
Mailing Address - Country:US
Mailing Address - Phone:919-646-6903
Mailing Address - Fax:
Practice Address - Street 1:10731 LAUREL CRK
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2443
Practice Address - Country:US
Practice Address - Phone:919-646-6903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health