Provider Demographics
NPI:1043438203
Name:FAMILY SERVICES OF SOUTHEAST TEXAS
Entity Type:Organization
Organization Name:FAMILY SERVICES OF SOUTHEAST TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:N
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:409-833-2668
Mailing Address - Street 1:990 INTERSTATE 10 N
Mailing Address - Street 2:SUITE 140
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1050
Mailing Address - Country:US
Mailing Address - Phone:409-833-2668
Mailing Address - Fax:409-899-9362
Practice Address - Street 1:990 INTERSTATE 10 N
Practice Address - Street 2:SUITE 140
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1050
Practice Address - Country:US
Practice Address - Phone:409-833-2668
Practice Address - Fax:409-899-9362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX04092101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty