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NPI Code Detail

MEDICARE: CHILDRENS ADVOCACY CENTER OF GRAYSON COUNTY

MEDICARE: CHILDRENS ADVOCACY CENTER OF GRAYSON COUNTY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor18459TX
2101YP2500XProfessional Counselor17819TX
3101YP2500XProfessional Counselor19101TX
4101YP2500XProfessional Counselor20329TX
5101YP2500XProfessional Counselor16137TX
6101YP2500XProfessional Counselor19737TX
7101YP2500XProfessional Counselor18627TX
8104100000XSocial Worker33929TX
9104100000XSocial Worker07159TX

General Provider Information

NPI Number : 1295942613
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDRENS ADVOCACY CENTER OF GRAYSON COUNTY
Provider Business Mailing Address
First Line : 910 COTTONWOOD DR
Second Line :
City : SHERMAN
State : TX
Zip : 75090-2831
Country : US
Telephone Number : 903-957-0440
Fax Number :
Provider Business Practice Location Address
First Line : 910 COTTONWOOD DR
Second Line :
City : SHERMAN
State : TX
Zip : 75090-2831
Country : US
Telephone Number : 903-957-0440
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MARTHA NUCKOLS
Credential :
Telephone Number : 903-957-0440
Provider Enumeration Date : 05/16/2007
Last Update Date : 09/11/2025

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Directions to “CHILDRENS ADVOCACY CENTER OF GRAYSON COUNTY ” Practice Location

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