Provider Demographics
NPI:1114214624
Name:ATKISON, JAMES RAY (LPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RAY
Last Name:ATKISON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8212 ITHACA AVE STE D5
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2637
Mailing Address - Country:US
Mailing Address - Phone:806-401-9404
Mailing Address - Fax:806-810-1682
Practice Address - Street 1:8212 ITHACA AVE STE D5
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2637
Practice Address - Country:US
Practice Address - Phone:806-401-9404
Practice Address - Fax:806-810-1682
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76514101Y00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX363651603Medicaid