Provider Demographics
NPI:1245387778
Name:BEHAVIORAL EMOTIONAL COUNSELING SERVICES
Entity Type:Organization
Organization Name:BEHAVIORAL EMOTIONAL COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NITA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:CHILDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-655-8569
Mailing Address - Street 1:1100 STONE ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KILGORE
Mailing Address - State:TX
Mailing Address - Zip Code:75662
Mailing Address - Country:US
Mailing Address - Phone:903-655-8569
Mailing Address - Fax:903-655-6481
Practice Address - Street 1:1100 STONE ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:KILGORE
Practice Address - State:TX
Practice Address - Zip Code:75662
Practice Address - Country:US
Practice Address - Phone:903-655-8569
Practice Address - Fax:903-655-6481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX318128OtherVALUE OPTIONS
TX0097DZOtherBLUE CROSS BLUE SHIELD
TX318128OtherVALUE OPTIONS