# SAMARITAN COUNSELING CENTER OF EAST TX, INC

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

## Provider details

- **NPI number:** 1841392727
- **Authorized official:** MRS. JAN L. RHODES LPC (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (936) 564-4064

## Contact information

- **Practice address:** 903 NORTH ST, NACOGDOCHES, TX 75961-4479
- **Practice address phone:** (936) 564-4064
- **Practice address fax:** (936) 564-1570
- **Mailing address:** 903 NORTH ST, NACOGDOCHES, TX 75961-4479
- **Mailing address phone:** (936) 564-4064
- **Mailing address fax:** (936) 564-1570

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 09/02/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00U07P | BLUE CROSS/BLUE SHIELD | TX |