Provider Demographics
NPI:1609894542
Name:MCKINNEY COUNCIL ON SUBSTANCE ABUSE, INC.
Entity Type:Organization
Organization Name:MCKINNEY COUNCIL ON SUBSTANCE ABUSE, INC.
Other - Org Name:AVENUES COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HANK
Authorized Official - Middle Name:
Authorized Official - Last Name:WICH
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:972-562-9647
Mailing Address - Street 1:201 W LOUISIANA ST
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-4415
Mailing Address - Country:US
Mailing Address - Phone:972-562-9647
Mailing Address - Fax:972-562-2383
Practice Address - Street 1:201 W LOUISIANA ST
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-4415
Practice Address - Country:US
Practice Address - Phone:972-562-9647
Practice Address - Fax:972-562-2383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 101YP2500X, 104100000X, 1041C0700X, 106H00000X
TX1908-A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty