Provider Demographics
NPI:1760782940
Name:LXE COUNSELING SERVICES
Entity Type:Organization
Organization Name:LXE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATWELL
Authorized Official - Suffix:
Authorized Official - Credentials:BA-BEHAVIORAL SCIENC
Authorized Official - Phone:903-715-8629
Mailing Address - Street 1:P.O. BOX 222
Mailing Address - Street 2:
Mailing Address - City:LANE
Mailing Address - State:OK
Mailing Address - Zip Code:74555
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 QUAIL RD
Practice Address - Street 2:
Practice Address - City:LANE
Practice Address - State:OK
Practice Address - Zip Code:74555
Practice Address - Country:US
Practice Address - Phone:903-715-8629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities