MEDICARE: JOAN M ARCHER LPC

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
1	101Y00000X	Counselor	04497	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	84052L	OTHER	TX	BLUE CROSS BLUE SHEILD

General Provider Information

NPI Number	:	1447398250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN M ARCHER LPC

Provider Business Mailing Address
First Line	:	4352 EMMETT F LOWRY EXPY
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591-2628
Country	:	US
Telephone Number	:	409-736-2373
Fax Number	:

Provider Business Practice Location Address
First Line	:	7510 FM 1765
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77590
Country	:	US
Telephone Number	:	409-935-6083
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/09/2007

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Directions to “ JOAN M ARCHER LPC” Practice Location

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