Provider Demographics
NPI:1124031869
Name:TEXARKANA REGIONAL COUNSELING SERVICES
Entity Type:Organization
Organization Name:TEXARKANA REGIONAL COUNSELING SERVICES
Other - Org Name:BEHAVIORAL HEALTH CENTER OF TEXARKANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LESA
Authorized Official - Middle Name:DONICE
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:903-334-8022
Mailing Address - Street 1:PO BOX 5725
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75505-5725
Mailing Address - Country:US
Mailing Address - Phone:903-334-8022
Mailing Address - Fax:903-334-7019
Practice Address - Street 1:5321 SUMMERHILL RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-1827
Practice Address - Country:US
Practice Address - Phone:903-334-8022
Practice Address - Fax:903-334-7019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX327261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00131WMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER