Organization Name: | CHILDREN'S CRISIS PREVENTION NETWORK, INC. |
NPI Number: | 1477833135 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD ELLIOTT WAGNER (LEAD THERAPIST) |
Mailing Address: | 7479 State Highway 19 S Athens |
State: | TX US |
Postal Code: | 757518979 |
Phone Number: | 9036773220 |
Fax Number: | 9036770710 |
NPI Enumeration Date: | 08/25/2011 |
NPI Last Update Date: | 08/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LPA- 12381 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |