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General NPI Number Information
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NPI Number | 1659336345
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Entity Type | Organization
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Legal Business Name | CHILD AND FAMILY GUIDANCE CENTER OF TEXOMA
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 804 PECAN GROVE RD E
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City | SHERMAN
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State | TX
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Zip | 75090-1767
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Country | US
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Telephone | 903-893-7768
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Fax | 903-893-4979
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Provider Business Mailing Address
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Address Line | 804 PECAN GROVE RD E
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City | SHERMAN
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State | TX
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Zip | 75090-1767
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Country | US
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Telephone | 903-893-7768
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Fax | 903-893-4979
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BRENDA HAYWARD
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Credential | M.B.A.
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Telephone | 903-893-7768
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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 | 27693
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health 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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 18459
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 901
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 16486
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11588
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 17384
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 18185
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License Number State | TX
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Taxonomy #9
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 14846
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License Number State | TX
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