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General NPI Number Information
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NPI Number | 1427741354
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Entity Type | Organization
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Legal Business Name | TEACHING OUR YOUTH EXCELLENCE
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 777 MAIN ST STE 600
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City | FORT WORTH
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State | TX
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Zip | 76102-5368
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Country | US
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Telephone | 682-438-3346
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Fax |
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Provider Business Mailing Address
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Address Line | 777 MAIN ST STE 600
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City | FORT WORTH
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State | TX
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Zip | 76102-5368
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Country | US
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Telephone | 682-438-3346
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH SPECIALIST
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Name | LAKISHA GIBSON
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Credential | DSHS CHW
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Telephone | 682-438-3346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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