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108 Wain Dr Ste B Longview TX 75604-1231 | |
| (903) 850-6334 | |
| (903) 236-8510 |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 108 Wain Dr Ste B, Longview, Texas |
| Authorized Official Name and Position | Deborah Chelette Wilson (SOLE MEMBER) |
| Authorized Official Contact | 9033652198 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1804 Livingston St Longview TX 75601-3724 Ph: (903) 850-6334 | 108 Wain Dr Ste B Longview TX 75604-1231 Ph: (903) 850-6334 |
| NPI Number | 1902079437 |
|---|---|
| Provider Enumeration Date | 04/04/2008 |
| Last Update Date | 03/31/2020 |
| Certification Date | 03/31/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902079437 | NPI | - | NPPES |
| 028036401 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 15127 (Texas) | Primary |
Heather R. Mcconnell, M.a., Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 911 W Loop 281, Suite 423, Longview, TX 75604 Phone: 903-759-2402 Fax: 903-759-2570 | |
Jonathan C. Lockhart, Md Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 911 W Loop 281, Suite 111, Longview, TX 75604 Phone: 903-295-8994 Fax: 903-295-8987 | |
Core Health Systems Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1300 N 6th St # A, Longview, TX 75601 Phone: 903-232-8928 Fax: 903-918-1813 | |
Willem H. Fahrenbruck, Lpc, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3122 Nealy Way Ste 201, Longview, TX 75605 Phone: 903-452-8040 | |
Diversified Psychological Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1508 W Fairmont St, Suite C, Longview, TX 75604 Phone: 903-238-9553 Fax: 903-291-8709 | |
7872 Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 615 Clinic Dr, Longview, TX 75605 Phone: 903-212-3105 |