# DOGWOOD MENTAL HEALTH AND WELLNESS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366865370
- **Authorized official:** DR. HASKELL STEPHEN COOPER PHD, LCSW (MANAGING MEMBER)
- **Authorized official phone:** (936) 622-0993

## Contact information

- **Practice address:** 412 NORTH ST, SUITE B, NACOGDOCHES, TX 75961-5077
- **Practice address phone:** (936) 622-0993
- **Practice address fax:** (936) 622-0994
- **Mailing address:** PO BOX 632279, NACOGDOCHES, TX 75963-2279
- **Mailing address phone:** (936) 622-0993
- **Mailing address fax:** (936) 622-0994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 34017 | TX | Yes |

## Other

- **Enumeration date:** 01/27/2014
- **Last updated:** 02/14/2014