Provider Demographics
NPI:1053986679
Name:PAST AND PRESENT THERAPY
Entity type:Organization
Organization Name:PAST AND PRESENT THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-917-5648
Mailing Address - Street 1:14552 ROBERT I WALKER BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-6800
Mailing Address - Country:US
Mailing Address - Phone:512-917-5648
Mailing Address - Fax:
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD
Practice Address - Street 2:BUILDING I SUITE 3
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7875
Practice Address - Country:US
Practice Address - Phone:512-827-9097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty