Provider Demographics
NPI:1750158531
Name:SOUTHWEST MENTAL HEALTH ASSOCIATES PLLC
Entity type:Organization
Organization Name:SOUTHWEST MENTAL HEALTH ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:COLE
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:806-438-8089
Mailing Address - Street 1:3513 50TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-4003
Mailing Address - Country:US
Mailing Address - Phone:806-412-4721
Mailing Address - Fax:806-500-2935
Practice Address - Street 1:3513 50TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-4003
Practice Address - Country:US
Practice Address - Phone:806-412-4721
Practice Address - Fax:806-500-2935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty