NPI | 1063574499 |
---|---|
Entity Type | Organization |
Authorized Contact | SUSAN CHRISTENSON Provider Enrollment Services 979-492-2795 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
101YM0800X Counselor Mental Health | |
101YP2500X Counselor Professional | |
103TC1900X Psychologist Counseling | |
104100000X Social Worker | |
1041C0700X Social Worker Clinical | |
106H00000X Marriage & Family Therapist | |
363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
Enumeration Date | 2006-12-14 |
Last Update Date | 2024-05-02 |