Provider Demographics
NPI:1184208654
Name:MAYFIELD AND ASSOCIATES
Entity Type:Organization
Organization Name:MAYFIELD AND ASSOCIATES
Other - Org Name:CENTER OF CULTIVATING PARENTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHANTEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:214-475-0445
Mailing Address - Street 1:2249 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5665
Mailing Address - Country:US
Mailing Address - Phone:214-475-0445
Mailing Address - Fax:972-637-4065
Practice Address - Street 1:1050 SW 6TH AVE STE 1100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-1153
Practice Address - Country:US
Practice Address - Phone:503-308-8287
Practice Address - Fax:972-637-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health