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3800 S W S Young Dr Ste 104a Killeen TX 76542-3312 | |
| (254) 519-1150 | |
| (254) 519-1151 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3800 S W S Young Dr Ste 104a, Killeen, Texas |
| Authorized Official Name and Position | Lusan Clark-ladd (PRESIDENT) |
| Authorized Official Contact | 2545191150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3800 S W S Young Dr Ste 104a Killeen TX 76542-3312 Ph: (254) 338-3737 | 3800 S W S Young Dr Ste 104a Killeen TX 76542-3312 Ph: (254) 519-1150 |
| NPI Number | 1811363344 |
|---|---|
| Provider Enumeration Date | 08/19/2015 |
| Last Update Date | 11/27/2023 |
| Certification Date | 11/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811363344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 64044 (Texas) | Primary |
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