Provider Demographics
NPI:1861794331
Name:COUTROS, J.J. (JD, MSW)
Entity type:Individual
Prefix:
First Name:J.J.
Middle Name:
Last Name:COUTROS
Suffix:
Gender:F
Credentials:JD, MSW
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:JEANNE
Other - Last Name:COUTROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6516 KINGS CROWN W
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-4700
Mailing Address - Country:US
Mailing Address - Phone:917-306-3161
Mailing Address - Fax:
Practice Address - Street 1:6516 KINGS CROWN W
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-4700
Practice Address - Country:US
Practice Address - Phone:917-306-3161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074794104100000X
TX54597104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker