Healthcare Provider Details
I. General information
NPI: 1972738086
Provider Name (Legal Business Name): ELIZABETH V. MEWHINNEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/18/2009
Last Update Date: 05/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
409 S GRAHAM ST
STEPHENVILLE TX
76401-4425
US
IV. Provider business mailing address
409 S GRAHAM ST
STEPHENVILLE TX
76401-4425
US
V. Phone/Fax
- Phone: 254-592-4244
- Fax:
- Phone: 254-592-4244
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 14178 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: