Provider Demographics
NPI:1609148105
Name:WEBB, BYRON THOMAS (LCSW, CART)
Entity Type:Individual
Prefix:MR
First Name:BYRON
Middle Name:THOMAS
Last Name:WEBB
Suffix:
Gender:M
Credentials:LCSW, CART
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 TWIN OAKS ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76302-2723
Mailing Address - Country:US
Mailing Address - Phone:940-696-0181
Mailing Address - Fax:940-696-5692
Practice Address - Street 1:1420 TWIN OAKS ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76302-2723
Practice Address - Country:US
Practice Address - Phone:940-696-0181
Practice Address - Fax:940-696-5692
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX515191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical