Healthcare Provider Details

I. General information

NPI: 1124566567
Provider Name (Legal Business Name): SOTERIA COUNSELING AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2017
Last Update Date: 02/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S CENTER ST SUITE 500
ARLINGTON TX
76010-7139
US

IV. Provider business mailing address

301 S CENTER ST SUITE 500
ARLINGTON TX
76010-7139
US

V. Phone/Fax

Practice location:
  • Phone: 817-276-6412
  • Fax:
Mailing address:
  • Phone: 817-276-6412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOE EASTHAM
Title or Position: DIRECTOR
Credential: LPC LMFT
Phone: 817-276-6412