Provider Demographics
NPI:1326009754
Name:SAMARITAN COUNSELING CENTER OF SOUTHEAST TEXAS
Entity Type:Organization
Organization Name:SAMARITAN COUNSELING CENTER OF SOUTHEAST TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:VANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-983-7668
Mailing Address - Street 1:3747 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-5555
Mailing Address - Country:US
Mailing Address - Phone:409-983-7668
Mailing Address - Fax:409-983-4761
Practice Address - Street 1:1305 ROOSEVELT DR
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656-3309
Practice Address - Country:US
Practice Address - Phone:877-385-3347
Practice Address - Fax:409-983-4761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty