Children's Crisis Prevention Network, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC- 20058 Issued in TX

Legal business name

CHILDREN'S CRISIS PREVENTION NETWORK, INC.

Doing business as

Community Care & Prevention Network

Practice address

7479 State Highway 19 S
Athens, TX 75751-8979

Phone

(903) 677-3220

Fax

(903) 677-0710

NPI assigned

Aug 25, 2011

Last updated

Aug 25, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Elliott Wagner, M.A., L.P.C.

Title

Lead Therapist

Phone

(903) 677-3220

Specialties & licenses 15

Addresses

Other names 1

• Community Care & Prevention Network Doing business as

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314230400000",
    "number": "1477833135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2464",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757517464",
            "telephone_number": "903-677-3220",
            "fax_number": "903-677-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7479 STATE HIGHWAY 19 S",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757518979",
            "telephone_number": "903-677-3220",
            "fax_number": "903-677-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CRISIS PREVENTION NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-25",
        "last_updated": "2011-08-25",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ELLIOTT",
        "authorized_official_title_or_position": "LEAD THERAPIST",
        "authorized_official_telephone_number": "903-677-3220",
        "authorized_official_credential": "M.A., L.P.C."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "TX",
            "license": "LPA- 12381",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "LCDC- 11123",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "CCDS- 0831-0991",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "LCDC- 6684",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "LCDC- 1066",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "LPC- 20058",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "LPC- 19613",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "LSSP-S 6100-S",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "LPC- 15979",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "LPC- 9187",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "LPC- 19349",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "LPC- 20058",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "LPC-S 13026",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": "TX",
            "license": "LSSP- 30134",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "LMFT- 000088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care & Prevention Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Athens, TX
• Providers in Athens, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.