Provider Demographics
NPI:1265772156
Name:ENLIVEN COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:ENLIVEN COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-274-5329
Mailing Address - Street 1:238 NATIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-4531
Mailing Address - Country:US
Mailing Address - Phone:210-274-5329
Mailing Address - Fax:210-979-9839
Practice Address - Street 1:8400 BLANCO RD
Practice Address - Street 2:STE. 206
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-3055
Practice Address - Country:US
Practice Address - Phone:210-274-5329
Practice Address - Fax:210-979-9839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67762251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health