Healthcare Provider Details

I. General information

NPI: 1720497480
Provider Name (Legal Business Name): HARVEST COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 01/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501-C SOUTH WHEELER STREET
JASPER TX
75951
US

IV. Provider business mailing address

1501-C SOUTH WHEELER STREET
JASPER TX
75951
US

V. Phone/Fax

Practice location:
  • Phone: 409-489-8299
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DAVID SCOTT HUGHES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 409-622-9252