Healthcare Provider Details

I. General information

NPI: 1699684910
Provider Name (Legal Business Name): CHISHOLM TRAIL MENTALHEALTH AND THERAPY SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 MILLENNIUM DR
CROWLEY TX
76036-1500
US

IV. Provider business mailing address

5900 BALCONES DR STE 100
AUSTIN TX
78731-4298
US

V. Phone/Fax

Practice location:
  • Phone: 817-901-2292
  • Fax:
Mailing address:
  • Phone: 512-318-2199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YAW AFRIYIE MARFO
Title or Position: PMHNP-BC
Credential: DNP, APRN
Phone: 817-901-2292