Provider Demographics
NPI:1003148453
Name:COUNSELING MANAGEMENT INC.
Entity Type:Organization
Organization Name:COUNSELING MANAGEMENT INC.
Other - Org Name:ACT COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:DORETHY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:432-333-3667
Mailing Address - Street 1:1901 E 37TH ST
Mailing Address - Street 2:STE.106
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-6201
Mailing Address - Country:US
Mailing Address - Phone:432-333-3667
Mailing Address - Fax:432-580-3115
Practice Address - Street 1:1901 E 37TH ST
Practice Address - Street 2:STE.106
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-6201
Practice Address - Country:US
Practice Address - Phone:432-333-3667
Practice Address - Fax:432-580-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1211101YM0800X
TX57908101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184909301Medicaid
TX027676801Medicaid