Healthcare Provider Details

I. General information

NPI: 1730953449
Provider Name (Legal Business Name): CENTER FOR EMOTIONAL WELLNESS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 W BUSINESS 380 STE 100
DECATUR TX
76234-3267
US

IV. Provider business mailing address

1602 W BUSINESS 380 STE 100
DECATUR TX
76234-3267
US

V. Phone/Fax

Practice location:
  • Phone: 940-539-0683
  • Fax: 940-228-0651
Mailing address:
  • Phone: 940-539-0683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KELLY SUZANNE JONES
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW-S
Phone: 940-626-3923