Provider Demographics
NPI:1679613129
Name:SAMARITAN COUNSELING CENTER
Entity Type:Organization
Organization Name:SAMARITAN COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:LCDC
Authorized Official - Phone:409-983-1668
Mailing Address - Street 1:745 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-4905
Mailing Address - Country:US
Mailing Address - Phone:409-892-3902
Mailing Address - Fax:
Practice Address - Street 1:3747 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-5555
Practice Address - Country:US
Practice Address - Phone:409-983-7668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6823101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty