Provider Demographics
NPI:1114590759
Name:CALICHE COUNSELING
Entity Type:Organization
Organization Name:CALICHE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLCORN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:806-337-0782
Mailing Address - Street 1:2309 SW 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-6601
Mailing Address - Country:US
Mailing Address - Phone:806-337-0782
Mailing Address - Fax:
Practice Address - Street 1:2309 SW 7TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-6601
Practice Address - Country:US
Practice Address - Phone:806-337-0782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1790325819OtherNPI