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General NPI Number Information
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NPI Number | 1043842750
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Entity Type | Organization
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Legal Business Name | MARY S STRONG CREATIVE COMMUNITY COUNSELING
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 12/10/2021
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Provider Practice Location Address
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Address Line | 719 S AUSTIN ST
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City | AMARILLO
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State | TX
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Zip | 79106-6714
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Country | US
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Telephone | 318-350-6767
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Fax | 318-350-6767
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Provider Business Mailing Address
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Address Line | 731 ACKLEN ST
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City | SHREVEPORT
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State | LA
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Zip | 71104-3901
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Country | US
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Telephone | 318-288-2686
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARY SOSONYA STRONG
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Credential | RSW, LPC, RPT, CAS
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Telephone | 318-288-2686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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