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Organization

BEHAVIORAL EMOTIONAL COUNSELING SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. FELICIA H WHITAKER LPC (CHIEF EXECUTIVE OFFICER)
(903) 986-9114
Entity
Organization

Contact information

Practice address
1100 STONE ROAD, SUITE 102, KILGORE, TX 75662-5494
(903) 986-9114
(903) 988-0243
Mailing address
1100 STONE ROAD, SUITE 102, KILGORE, TX 75662-5494
(903) 986-9114
(903) 988-0243

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0097DZ
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/16/2006
Last updated
08/22/2020
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