# ALLEGIANCE MENTAL HEALTH & WELLNESS SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ALLEGIANCE MENTAL HEALTH, ALLEGIANCE COUNSELING, ALLEGIANCE WELLNESS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760107387
- **Authorized official:** MR. THEOPHLIUS WATSON III LCSW-S (MANAGING MEMBER)
- **Authorized official phone:** (505) 227-4338

## Contact information

- **Practice address:** 605 AUSTIN AVE, WACO, TX 76701-2048
- **Practice address phone:** (254) 900-7986
- **Mailing address:** 605 AUSTIN AVE, WACO, TX 76701-2048
- **Mailing address phone:** (254) 900-7986

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 106S00000X | Behavior Technician | — | NULL | — |
| 106S00000X | Behavior Technician | — | — | — |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 171400000X | Health & Wellness Coach | — | NULL | — |
| 171400000X | Health & Wellness Coach | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | — |

## Other

- **Enumeration date:** 10/06/2022
- **Last updated:** 03/21/2025