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General NPI Number Information
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NPI Number | 1467775510
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Entity Type | Organization
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Legal Business Name | FIRST STEP DENTON COUNTY OUTREACH PROGRAM, LLC
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 1406 N CORINTH ST STE 401
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City | CORINTH
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State | TX
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Zip | 76208-5449
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Country | US
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Telephone | 940-497-5576
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Fax | 940-497-5585
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Provider Business Mailing Address
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Address Line | 1406 NORTH CORINTH STREET SUITE 401
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City | CORINTH
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State | TX
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Zip | 76208-5449
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Country | US
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Telephone | 940-497-5576
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Fax | 940-497-5585
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROY EDWARD CULBERSON
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Credential |
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Telephone | 940-497-5576
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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 | 5244
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 5244
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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 | 5244
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 5244
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 5244
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 5244
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | 5244
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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 | 5244
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License Number State | TX
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Taxonomy #9
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 5244
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License Number State | TX
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Taxonomy #10
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 5244
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License Number State | TX
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Taxonomy #11
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 5244
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License Number State | TX
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Taxonomy #12
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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