Provider Demographics
NPI:1063656668
Name:ABRAM STREET COUNSELING CENTER
Entity Type:Organization
Organization Name:ABRAM STREET COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:HOBART
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:817-633-7490
Mailing Address - Street 1:2309 ROOSEVELT DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-5718
Mailing Address - Country:US
Mailing Address - Phone:817-633-7490
Mailing Address - Fax:817-633-7436
Practice Address - Street 1:2309 ROOSEVELT DR
Practice Address - Street 2:SUITE C
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-5718
Practice Address - Country:US
Practice Address - Phone:817-633-7490
Practice Address - Fax:817-633-7436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25851251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1235272493OtherRENDERING NPI