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General NPI Number Information
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NPI Number | 1477991313
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Entity Type | Organization
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Legal Business Name | FIRST UNITED METHODIST CHURCH COUNSELING CENTER
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Dates
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Enumeration Date | 06/13/2013
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 1411 BROADWAY
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City | LUBBOCK
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State | TX
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Zip | 79401-3207
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Country | US
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Telephone | 806-763-4607
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Fax | 806-763-7252
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Provider Business Mailing Address
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Address Line | 1411 BROADWAY
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City | LUBBOCK
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State | TX
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Zip | 79401-3207
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Country | US
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Telephone | 806-763-4607
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Fax | 806-763-7252
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SHERA JOY ATKINSON
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Credential | PH.D.
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Telephone | 806-763-4607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 12865
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License Number State | TX
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