Active NPI
Supportive Shores: Family & Therapy Services
- Clinical Social Worker
- Mount Vernon, TX
National Provider Identifier
1104733831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- SUPPORTIVE SHORES: FAMILY & THERAPY SERVICES
- Practice address
- 203 Kaufman St N
Mount Vernon, TX 75457-2309 - Phone
- (903) 347-2727
- NPI assigned
- Aug 26, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Allison Marie Agan, MSW, LCSW
- Title
- Owner
- Phone
- (903) 347-2727
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
203 Kaufman St N
Mount Vernon, TX 75457-2309
Mailing address
PO Box 841
Mount Vernon, TX 75457-0841
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787702400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788393600000",
"number": "1104733831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 841",
"city": "MOUNT VERNON",
"state": "TX",
"postal_code": "754570841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 KAUFMAN ST N",
"city": "MOUNT VERNON",
"state": "TX",
"postal_code": "754572309",
"telephone_number": "903-347-2727"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPPORTIVE SHORES: FAMILY & THERAPY SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2026-08-26",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A",
"authorized_official_last_name": "AGAN",
"authorized_official_first_name": "ALLISON",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "903-347-2727",
"authorized_official_credential": "MSW, LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.