Provider Demographics
NPI:1922057769
Name:TAFT COUNSELING CENTER INC
Entity Type:Organization
Organization Name:TAFT COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KJAER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-691-1899
Mailing Address - Street 1:4722 TAFT BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-4800
Mailing Address - Country:US
Mailing Address - Phone:940-691-1899
Mailing Address - Fax:940-691-3423
Practice Address - Street 1:4722 TAFT BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-4800
Practice Address - Country:US
Practice Address - Phone:940-691-1899
Practice Address - Fax:940-691-3423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19361101YP2500X
TX19099101YP2500X
TX31569103TB0200X
TX002381106H00000X
TX003347106H00000X
TX004954106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOOU97XOtherBLUE CROSS
TX079830801Medicaid