Healthcare Provider Details

I. General information

NPI: 1841392727
Provider Name (Legal Business Name): SAMARITAN COUNSELING CENTER OF EAST TX, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 NORTH ST
NACOGDOCHES TX
75961-4479
US

IV. Provider business mailing address

903 NORTH ST
NACOGDOCHES TX
75961-4479
US

V. Phone/Fax

Practice location:
  • Phone: 936-564-4064
  • Fax: 936-564-1570
Mailing address:
  • Phone: 936-564-4064
  • Fax: 936-564-1570

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: MRS. JAN L. RHODES
Title or Position: EXECUTIVE DIRECTOR
Credential: LPC
Phone: 936-564-4064