Third Space Counseling and Consultation, PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

17621 Issued in TX

Legal business name

THIRD SPACE COUNSELING AND CONSULTATION, PLLC

Practice address

1380 Pantheon Way Suite 245
San Antonio, TX 78232

Phone

(210) 602-9499

NPI assigned

Sep 3, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeff Gatlin, LPC-S

Title

President

Phone

(210) 602-9499

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504396800000",
    "number": "1003334616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 SALT LICK RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78232",
            "telephone_number": "210-602-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 PANTHEON WAY SUITE 245",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78232",
            "telephone_number": "210-602-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD SPACE COUNSELING AND CONSULTATION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-03",
        "last_updated": "2017-09-03",
        "status": "A",
        "authorized_official_last_name": "GATLIN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-602-9499",
        "authorized_official_credential": "LPC-S"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "17621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.