Organization
ROSE STREET MENTAL HEALTH CARE, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON WINTER (OFFICE MANAGER)
(940) 322-9456
Entity
Organization
Contact information
Practice address
1808 ROSE ST, WICHITA FALLS, TX 76301-4219
(940) 723-4488
(940) 723-0446
Mailing address
1808 ROSE ST, WICHITA FALLS, TX 76301-4219
(940) 723-4488
(940) 723-0446
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
TX
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
TX
1041C0700X
Clinical Social Worker
—
TX
2084P0800X
Psychiatry Physician
Primary
—
TX
363L00000X
Nurse Practitioner
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124521
SUPERIOR
TX
05
—
160113001
—
TX
05
—
200065400A
—
OK
01
—
295881
VALUEOPTIONS
TX
Enumeration date
07/20/2005
Last updated
07/21/2022
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