Provider Demographics
NPI:1003369679
Name:TEXAS COUNSELING CENTER
Entity Type:Organization
Organization Name:TEXAS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, MENTAL HEALTH
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LACKEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:409-883-9940
Mailing Address - Street 1:610 STRICKLAND DR STE 320
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-4788
Mailing Address - Country:US
Mailing Address - Phone:409-883-9940
Mailing Address - Fax:
Practice Address - Street 1:610 STRICKLAND DR STE 320
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4788
Practice Address - Country:US
Practice Address - Phone:409-883-9940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67594101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X, 106H00000X
TX11455101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty