Organization
ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES
Active
Other names
ACCESS
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNA STROM (REIMBURSEMENT COORDINATOR)
(903) 589-9000
Entity
Organization
Contact information
Practice address
1011 COLLEGE AVE, JACKSONVILLE, TX 75766
(903) 589-9000
Mailing address
1011 COLLEGE AVE, JACKSONVILLE, TX 75766-3307
(903) 589-9000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
17029
TX
101YM0800X
Mental Health Counselor
63332
TX
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
163WC1500X
Community Health Registered Nurse
618031
TX
163WC1500X
Community Health Registered Nurse
674004
TX
164X00000X
Licensed Vocational Nurse
051913
TX
2084P0800X
Psychiatry Physician
H5197
TX
2084P0800X
Psychiatry Physician
K2150
TX
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T09Z
BLUE CROSS BLUE SHIELD
TX
05
—
111411803
—
TX
Enumeration date
02/28/2007
Last updated
06/12/2024
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