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General NPI Number Information
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NPI Number | 1295942613
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Entity Type | Organization
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Legal Business Name | CHILDRENS ADVOCACY CENTER OF GRAYSON COUNTY
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 910 COTTONWOOD DR
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City | SHERMAN
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State | TX
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Zip | 75090-2831
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Country | US
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Telephone | 903-957-0440
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Fax |
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Provider Business Mailing Address
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Address Line | 910 COTTONWOOD DR
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City | SHERMAN
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State | TX
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Zip | 75090-2831
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Country | US
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Telephone | 903-957-0440
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARTHA NUCKOLS
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Credential |
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Telephone | 903-957-0440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 18459
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 17819
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19101
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 20329
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 16137
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19737
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 18627
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 33929
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License Number State | TX
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Taxonomy #9
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 07159
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License Number State | TX
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