Doctor Name: | JAMES MICHAEL HARGRAVE |
NPI Number: | 1649633652 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCDC,CEAP |
License Number: | 004160 |
Business Practice Address: | 3608 Melody Ln Texarkana, TX - 755030884 |
Business Phone Number: | 9032937485 |
Business Fax Number: | 9036147100 |
Mailing Address: | 3608 Melody Ln, TEXARKANA |
State: | TX |
Postal Code: | 755030884 |
Phone Number: | 9032937485 |
Fax Number: | 9036147100 |
NPI Enumeration Date: | 03/29/2016 |
NPI Last Update Date: | 03/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 004160 |
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 |