Organization Active NPI

McLennan County

  • Counselor
  • Waco, TX
National Provider Identifier
1104123926
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
19676 Issued in TX
Legal business name
MCLENNAN COUNTY
Practice address
2601 Gholson Rd
Waco, TX 76704-1106
Phone
(254) 757-5072
Fax
(254) 799-4902
NPI assigned
Feb 14, 2011
Organization subpart
Yes
Parent organization
MCLENNAN COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Robert Campos, BSW
Title
Director (Chief Probation Officer)
Phone
(254) 757-5072

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 19676 TX Primary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X 19676 TX

Addresses

Primary practice location

2601 Gholson Rd
Waco, TX 76704-1106

Mailing address

2601 Gholson Rd
Waco, TX 76704-1106
Phone (254) 757-5072

Other names 1

  • Bill Logue Juvenile Justice Center Other name

National Provider Directory

National Provider Directory
Part of
McLennan County

Locations

2601 Gholson Rd
Waco, TX 76704
Phone (254) 299-8880

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1104123926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 GHOLSON RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767041106",
            "telephone_number": "254-757-5072",
            "fax_number": "254-799-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 GHOLSON RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767041106",
            "telephone_number": "254-757-5072",
            "fax_number": "254-799-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLENNAN COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLENNAN COUNTY",
        "enumeration_date": "2011-02-14",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "CAMPOS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR (CHIEF PROBATION OFFICER)",
        "authorized_official_telephone_number": "254-757-5072",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "TX",
            "license": "19676",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "TX",
            "license": "19676",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bill Logue Juvenile Justice Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.