Organization
CHILD AND FAMILY GUIDANCE CENTER OF TEXOMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA HAYWARD M.B.A. (EXECUTIVE DIRECTOR)
(903) 893-7768
Entity
Organization
Contact information
Practice address
804 PECAN GROVE RD E, SHERMAN, TX 75090-1767
(903) 893-7768
(903) 893-4979
Mailing address
804 PECAN GROVE RD E, SHERMAN, TX 75090-1767
(903) 893-7768
(903) 893-4979
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
14846
TX
101YM0800X
Mental Health Counselor
16486
TX
101YM0800X
Mental Health Counselor
17384
TX
101YM0800X
Mental Health Counselor
17819
TX
101YM0800X
Mental Health Counselor
18185
TX
101YM0800X
Mental Health Counselor
18459
TX
101YM0800X
Mental Health Counselor
901
TX
1041C0700X
Clinical Social Worker
11588
TX
1041C0700X
Clinical Social Worker
27693
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00N35N
BCBS GROUP NUMBER
TX
05
—
084154601
—
TX
05
—
084154602
—
TX
01
—
5390719
INDIVIDUAL AETNA NUMBER
TX
01
—
82844L
INDIVIDUAL BCBS NUMBER
TX
01
—
83343L
INDIVIDUAL BCBS NUMBER
TX
01
—
83590L
INDIVIDUAL BCBS NUMBER
TX
01
—
84347L
INDIVIDUAL BCBS NUMBER
TX
01
—
87190Q
INDIVIDUAL BCBS NUMBER
TX
Enumeration date
04/18/2006
Last updated
07/22/2008
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