Organization
SHILOH COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD MADOC THOMAS PH.D (DIRECTOR AND OWNER)
(806) 794-3232
Entity
Organization
Contact information
Practice address
4630 50TH ST, SUITE 412, LUBBOCK, TX 79414-3521
(806) 794-3232
Mailing address
4630 50TH ST, SUITE 412, LUBBOCK, TX 79414-3521
(806) 794-3232
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010BG
BLUE CROSS BLUE SHIELD
TX
Enumeration date
03/29/2007
Last updated
08/22/2020
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