Healthcare Provider Details

I. General information

NPI: 1679018287
Provider Name (Legal Business Name): KRANZ PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2017
Last Update Date: 07/19/2021
Certification Date: 06/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3118 H G MOSLEY PKWY
LONGVIEW TX
75605-2941
US

IV. Provider business mailing address

3118 H G MOSLEY PKWY
LONGVIEW TX
75605-2941
US

V. Phone/Fax

Practice location:
  • Phone: 903-200-1433
  • Fax: 903-405-4047
Mailing address:
  • Phone: 903-200-1433
  • Fax: 903-405-4047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number37133
License Number StateTX
# 6
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY SCHUBARTH
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 903-200-1433