Provider Demographics
NPI:1477991313
Name:FIRST UNITED METHODIST CHURCH COUNSELING CENTER
Entity Type:Organization
Organization Name:FIRST UNITED METHODIST CHURCH COUNSELING CENTER
Other - Org Name:FUMC COUNSELING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:806-763-4607
Mailing Address - Street 1:1411 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79401-3207
Mailing Address - Country:US
Mailing Address - Phone:806-763-4607
Mailing Address - Fax:806-763-7252
Practice Address - Street 1:1411 BROADWAY
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79401-3207
Practice Address - Country:US
Practice Address - Phone:806-763-4607
Practice Address - Fax:806-763-7252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12865251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health