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General NPI Number Information
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NPI Number | 1912239757
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Entity Type | Organization
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Legal Business Name | PATHSTONES COUNSELING CENTER
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 11/05/2013
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Provider Practice Location Address
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Address Line | 610 E LOOP 281
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City | LONGVIEW
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State | TX
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Zip | 75605-5003
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Country | US
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Telephone | 903-248-2480
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Fax | 903-248-2481
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Provider Business Mailing Address
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Address Line | 610 E LOOP 281
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City | LONGVIEW
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State | TX
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Zip | 75605-5003
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Country | US
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Telephone | 903-248-2480
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Fax | 903-248-2481
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. CHRIS CUMMINGS
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Credential | LMFT, LCDC
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Telephone | 903-248-2480
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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 |
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License Number State |
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