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Contact Information

ST JOSEPH COUNSELING & REHABILITATION SERVICES, INC
3334 S SW LOOP 323
SUITE 108
TYLER, TX75701-9237
 Phone: 903-581-7973
 Fax: 903-581-6605
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counselor

101Y00000X
 

Mental Health

101YM0800X
 

Rehabilitation

103TR0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for ST JOSEPH COUNSELING & REHABILITATION SERVICES, INC

NPI # 1710251012
LBN Legal business name ST JOSEPH COUNSELING & REHABILITATION SERVICES, INC
Authorized official KEN CHINWEZE - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 03/05/2012
Last updated 04/16/2012 - About 14 years ago
Identifiers
LA Medicaid 1194941518
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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