Provider Demographics
NPI:1841495629
Name:EL PASO AREA CHRISTIAN COUNSELING SERVICE, INC.
Entity type:Organization
Organization Name:EL PASO AREA CHRISTIAN COUNSELING SERVICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CONTRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:915-772-2237
Mailing Address - Street 1:6044 GATEWAY BLVD E
Mailing Address - Street 2:SUITE 506
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2023
Mailing Address - Country:US
Mailing Address - Phone:915-772-2237
Mailing Address - Fax:915-772-2247
Practice Address - Street 1:6044 GATEWAY BLVD E
Practice Address - Street 2:SUITE 506
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2023
Practice Address - Country:US
Practice Address - Phone:915-772-2237
Practice Address - Fax:915-772-2247
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EL PASO AREA CHRISTIAN COUNSELING SERVICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-20
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9967101YA0400X
TX60484101YP2500X
TX200869106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200869OtherLMFT
TX60484OtherLPC
TX16564OtherLPC