Organization
COUNSELING INNOVATION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLENE MCCAULEY MAYFIELD LPC (OWNER)
(903) 284-1975
Entity
Organization
Contact information
Practice address
514 E COMMERCE ST, JACKSONVILLE, TX 75766-4910
(903) 284-1975
Mailing address
514 E COMMERCE ST, JACKSONVILLE, TX 75766-4910
(903) 284-1974
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/19/2012
Last updated
09/21/2012
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