Provider Demographics
NPI:1861861601
Name:AMARILLO COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:AMARILLO COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:BASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:806-372-1092
Mailing Address - Street 1:4200 RIDGECREST CIR STE B7&B8
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-5416
Mailing Address - Country:US
Mailing Address - Phone:806-372-1092
Mailing Address - Fax:
Practice Address - Street 1:4200 RIDGECREST CIR STE B7&B8
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-5416
Practice Address - Country:US
Practice Address - Phone:806-372-1092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty