Provider Demographics
NPI:1891564969
Name:TEXARKANA ECLECTIC COUNSELING, PLLC
Entity Type:Organization
Organization Name:TEXARKANA ECLECTIC COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WARD-GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-824-6024
Mailing Address - Street 1:3507 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:AR
Mailing Address - Zip Code:71854-2328
Mailing Address - Country:US
Mailing Address - Phone:903-824-6024
Mailing Address - Fax:
Practice Address - Street 1:4140 MCKNIGHT RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-0921
Practice Address - Country:US
Practice Address - Phone:903-824-6024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty