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General NPI Number Information
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NPI Number | 1043438203
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Entity Type | Organization
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Legal Business Name | FAMILY SERVICES OF SOUTHEAST TEXAS
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 990 INTERSTATE 10 N SUITE 140
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City | BEAUMONT
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State | TX
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Zip | 77702-1050
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Country | US
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Telephone | 409-833-2668
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Fax | 409-899-9362
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Provider Business Mailing Address
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Address Line | 990 INTERSTATE 10 N SUITE 140
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City | BEAUMONT
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State | TX
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Zip | 77702-1050
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Country | US
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Telephone | 409-833-2668
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Fax | 409-899-9362
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. JANET N WALKER
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Credential | LCSW
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Telephone | 409-833-2668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 04092
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License Number State | TX
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