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Organization

HUGULEY PSYCHOTHERAPY CLINIC, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SYLVIA JOY BLACK LCSW (PRESIDENT)
(817) 558-2988
Entity
Organization

Contact information

Practice address
214 N CADDO ST, CLEBURNE, TX 76031-4904
(817) 558-2988
Mailing address
214 N CADDO ST, CLEBURNE, TX 76031-4904
(817) 558-2988

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S14390
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1197543-06
TX
01
124649
MHN
TX
01
183595
VALUE OPTIONS
TX
01
6275711
UBH
TX
Enumeration date
04/15/2008
Last updated
04/20/2011
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