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General NPI Number Information
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NPI Number | 1215070362
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Entity Type | Organization
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Legal Business Name | BUCKNER CHILDREN & FAMILY SERVICES OF DEEP EAST TEXAS
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3402 DANIEL MCCALL DR STE 21
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City | LUFKIN
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State | TX
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Zip | 75904-7191
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Country | US
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Telephone | 936-637-3300
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Fax | 936-634-3384
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Provider Business Mailing Address
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Address Line | 3402 DANIEL MCCALL DR STE 21
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City | LUFKIN
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State | TX
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Zip | 75904-7191
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Country | US
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Telephone | 936-637-3300
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Fax | 936-634-3384
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JUDY MORGAN
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Credential |
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Telephone | 936-637-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW16181
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License Number State | TX
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