MEDICARE: AMES COUNSELING AND FAMILY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	16448	TX

General Provider Information

NPI Number	:	1912158965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMES COUNSELING AND FAMILY SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 696
Second Line	:
City	:	MOUNT ENTERPRISE
State	:	TX
Zip	:	75681-0696
Country	:	US
Telephone Number	:	903-754-9094
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 W RUSK ST
Second Line	:
City	:	MOUNT ENTERPRISE
State	:	TX
Zip	:	75681-7427
Country	:	US
Telephone Number	:	903-754-9094
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JAMES M. CALLOWAY
Credential	:	LPC
Telephone Number	:	903-754-9094

Provider Enumeration Date	:	10/08/2008
Last Update Date	:	10/08/2008

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