Organization
CHILDREN'S CRISIS PREVENTION NETWORK, INC.
Active
Other names
Community Care & Prevention Network
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD ELLIOTT WAGNER M.A., L.P.C. (LEAD THERAPIST)
(903) 677-3220
Entity
Organization
Contact information
Practice address
7479 STATE HIGHWAY 19 S, ATHENS, TX 75751-8979
(903) 677-3220
(903) 677-0710
Mailing address
PO BOX 2464, ATHENS, TX 75751-7464
(903) 677-3220
(903) 677-0710
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPA- 12381
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
CCDS- 0831-0991
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDC- 1066
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDC- 11123
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDC- 6684
TX
101YM0800X
Mental Health Counselor
Primary
LPC- 20058
TX
101YP2500X
Professional Counselor
LPC- 15979
TX
101YP2500X
Professional Counselor
LPC- 19349
TX
101YP2500X
Professional Counselor
LPC- 19613
TX
101YP2500X
Professional Counselor
LPC- 20058
TX
101YP2500X
Professional Counselor
LPC- 9187
TX
101YP2500X
Professional Counselor
LPC-S 13026
TX
101YP2500X
Professional Counselor
LSSP-S 6100-S
TX
103TS0200X
School Psychologist
LSSP- 30134
TX
106H00000X
Marriage & Family Therapist
LMFT- 000088
TX
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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