Provider Demographics
NPI:1639610413
Name:SOUTH TEXAS COUNSELING AND MENTORING AGENCY
Entity Type:Organization
Organization Name:SOUTH TEXAS COUNSELING AND MENTORING AGENCY
Other - Org Name:STXCMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TWYMON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-914-0671
Mailing Address - Street 1:2425 HARBOR CHASE DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3455
Mailing Address - Country:US
Mailing Address - Phone:281-914-0671
Mailing Address - Fax:
Practice Address - Street 1:2425 HARBOR CHASE DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3455
Practice Address - Country:US
Practice Address - Phone:281-914-0671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care AgencyGroup - Multi-Specialty