Healthcare Provider Details

I. General information

NPI: 1043146889
Provider Name (Legal Business Name): EXPEDITION BEHAVIORAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 CIVIC CIR STE 1005
AMARILLO TX
79109-1853
US

IV. Provider business mailing address

2201 CIVIC CIR STE 1005
AMARILLO TX
79109-1853
US

V. Phone/Fax

Practice location:
  • Phone: 806-214-1225
  • Fax: 806-414-3441
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHARON VASQUEZ
Title or Position: OWNER
Credential: LPC
Phone: 806-214-1225