Provider Demographics
NPI:1871236810
Name:COUNSELING CENTER OF EAST TEXAS PLLC
Entity Type:Organization
Organization Name:COUNSELING CENTER OF EAST TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LPC LMFT
Authorized Official - Phone:936-414-2022
Mailing Address - Street 1:PO BOX 150255
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75915-0255
Mailing Address - Country:US
Mailing Address - Phone:936-414-2022
Mailing Address - Fax:936-639-3680
Practice Address - Street 1:600 S JOHN REDDITT DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3121
Practice Address - Country:US
Practice Address - Phone:936-414-2022
Practice Address - Fax:936-875-3124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)