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619 E. Crosby Ave. El Paso TX 79902 | |
| (915) 444-8003 | |
| (915) 257-6501 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 619 E. Crosby Ave., El Paso, Texas |
| Authorized Official Name and Position | Rochelle Shamaley-middleton (OWNER) |
| Authorized Official Contact | 9154974300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
619 E. Crosby Ave. El Paso TX 79902 Ph: (915) 444-8003 | 619 E. Crosby Ave. El Paso TX 79902 Ph: (915) 444-8003 |
| NPI Number | 1699241786 |
|---|---|
| Provider Enumeration Date | 10/16/2018 |
| Last Update Date | 08/22/2022 |
| Certification Date | 08/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699241786 | NPI | - | NPPES |
| 404590801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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