Provider Demographics
NPI:1164542783
Name:SHILOH COUNSELING SERVICES
Entity Type:Organization
Organization Name:SHILOH COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:MADOC
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:806-794-3232
Mailing Address - Street 1:4630 50TH ST
Mailing Address - Street 2:SUITE 412
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-3521
Mailing Address - Country:US
Mailing Address - Phone:806-794-3232
Mailing Address - Fax:
Practice Address - Street 1:4630 50TH ST
Practice Address - Street 2:SUITE 412
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-3521
Practice Address - Country:US
Practice Address - Phone:806-794-3232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0010BGOtherBLUE CROSS BLUE SHIELD