MEDICARE: TEXOMA SPECIALTY COUNSELING PLLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1891541926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXOMA SPECIALTY COUNSELING PLLC

Provider Business Mailing Address
First Line	:	1800 TEAGUE DR STE 510
Second Line	:
City	:	SHERMAN
State	:	TX
Zip	:	75090-2656
Country	:	US
Telephone Number	:	888-659-7618
Fax Number	:	888-659-7618

Provider Business Practice Location Address
First Line	:	1800 TEAGUE DR STE 510
Second Line	:
City	:	SHERMAN
State	:	TX
Zip	:	75090-2656
Country	:	US
Telephone Number	:	888-659-7618
Fax Number	:	888-659-7618

Authorized Official
Title or Position	:	CEO/DIRECTOR
Name	:	DR. STEPHANIE WAITT
Credential	:	LPC-S, CEDS
Telephone Number	:	254-723-0673

Provider Enumeration Date	:	04/29/2024
Last Update Date	:	03/25/2025

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