| NPI | 1669295937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL SMITH President Of Program Management 877-387-1018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC0700X Psychologist, Clinical | |
| 103TC1900X Psychologist, Counseling | |
| 103TH0004X Psychologist, Health | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 106H00000X Marriage & Family Therapist | |
| 171000000X Military Health Care Provider | |
| 171400000X Health & Wellness Coach | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2024-11-05 |