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General NPI Number Information
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NPI Number | 1992506729
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Entity Type | Organization
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Legal Business Name | NEURO-FORGE THERAPY
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 2417 HOBBS RD STE 102
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City | AMARILLO
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State | TX
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Zip | 79109-1533
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Country | US
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Telephone | 806-676-9315
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Fax | 806-318-3046
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Provider Business Mailing Address
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Address Line | PO BOX 3742
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City | AMARILLO
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State | TX
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Zip | 79116-3742
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Country | US
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Telephone | 806-676-9315
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Fax | 806-318-3046
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Authorized Official
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Title or Position | CEO
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Name | MRS. MELISSA LYNN PREECE
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Credential | LCSW-S, LCDC
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Telephone | 806-676-9315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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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 |
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License Number State |
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