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General NPI Number Information
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NPI Number | 1760765911
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Entity Type | Organization
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Legal Business Name | WHITEHEAD BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | 722 MORGAN BLVD SUITE V
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City | HARLINGEN
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State | TX
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Zip | 78550-5139
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Country | US
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Telephone | 956-244-1747
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Fax |
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Provider Business Mailing Address
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Address Line | 1144 FAIRWAY
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City | HARLINGEN
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State | TX
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Zip | 78552-1781
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Country | US
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Telephone | 956-244-1747
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | CAROL WHITEHED
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Credential | LCSW-C
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Telephone | 956-244-1747
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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 | 54515
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License Number State | TX
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