Provider Demographics
NPI:1518401041
Name:AMARILLO PROFESSIONAL COUNSELING AND CONSULTATION PLLC
Entity Type:Organization
Organization Name:AMARILLO PROFESSIONAL COUNSELING AND CONSULTATION PLLC
Other - Org Name:APCC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:RHEA
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC-S
Authorized Official - Phone:806-344-2400
Mailing Address - Street 1:4200 RIDGECREST CIR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-5416
Mailing Address - Country:US
Mailing Address - Phone:806-443-5362
Mailing Address - Fax:888-393-2231
Practice Address - Street 1:4200 RIDGECREST CIR
Practice Address - Street 2:SUITE A-6
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-5416
Practice Address - Country:US
Practice Address - Phone:806-443-5362
Practice Address - Fax:888-393-2231
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERIZ HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64835101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty