| Counseling And Psychological Services Of East Texas, Pc | |
|
301 N Wellington St Marshall TX 75670-3335 | |
| (903) 938-4476 | |
| (903) 938-4125 |
| Full Name | Counseling And Psychological Services Of East Texas, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 301 N Wellington St, Marshall, Texas |
| Authorized Official Name and Position | Toney L Charles (PRESIDENT) |
| Authorized Official Contact | 9039384476 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling And Psychological Services Of East Texas, Pc Po Box 8317 Marshall TX 75671-8317 Ph: (903) 938-4476 | Counseling And Psychological Services Of East Texas, Pc 301 N Wellington St Marshall TX 75670-3335 Ph: (903) 938-4476 |
| NPI Number | 1134330392 |
|---|---|
| Provider Enumeration Date | 05/26/2007 |
| Last Update Date | 10/30/2013 |
| Medicare PECOS PAC ID | 8123001039 |
|---|---|
| Medicare Enrollment ID | O20040611000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134330392 | NPI | - | NPPES |
| 146704502 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Toney L Charles |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174695787 PECOS PAC ID: 8921012576 Enrollment ID: I20130909000186 |
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