Organization Active NPI

Child and Family Guidance Center of Texoma

  • Mental Health Counselor
  • Sherman, TX
National Provider Identifier
1659336345
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
14846 Issued in TX
Legal business name
CHILD AND FAMILY GUIDANCE CENTER OF TEXOMA
Practice address
804 Pecan Grove Rd E
Sherman, TX 75090-1767
Phone
(903) 893-7768
Fax
(903) 893-4979
NPI assigned
Apr 18, 2006
Last updated
Jul 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Authorized official

Name
Brenda Hayward, M.B.A.
Title
Executive Director
Phone
(903) 893-7768

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 14846 TX Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 17819 TX
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 18459 TX
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 901 TX
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 16486 TX
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 17384 TX
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 18185 TX
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 27693 TX
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 11588 TX

Addresses

Primary practice location

804 Pecan Grove Rd E
Sherman, TX 75090-1767

Mailing address

804 Pecan Grove Rd E
Sherman, TX 75090-1767
Phone (903) 893-7768

Other identifiers 9

IdentifierTypeStateIssuer
82844LOtherTXINDIVIDUAL BCBS NUMBER
83590LOtherTXINDIVIDUAL BCBS NUMBER
084154602MedicaidTX
5390719OtherTXINDIVIDUAL AETNA NUMBER
00N35NOtherTXBCBS GROUP NUMBER
83343LOtherTXINDIVIDUAL BCBS NUMBER
87190QOtherTXINDIVIDUAL BCBS NUMBER
84347LOtherTXINDIVIDUAL BCBS NUMBER
084154601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190225002045 TX Part B Supplier - Clinic/Group Practice 7911246657 Receives reassigned benefits from 9 practitioners
Practice locations: Sherman, TX

National Provider Directory

National Provider Directory

Locations

804 Pecan Grove Rd E
Sherman, TX 75090
Phone (903) 893-7768

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1659336345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 PECAN GROVE RD E",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750901767",
            "telephone_number": "903-893-7768",
            "fax_number": "903-893-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 PECAN GROVE RD E",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750901767",
            "telephone_number": "903-893-7768",
            "fax_number": "903-893-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD AND FAMILY GUIDANCE CENTER OF TEXOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "HAYWARD",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "903-893-7768",
        "authorized_official_credential": "M.B.A."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "14846",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "17819",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "18459",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "901",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "16486",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "17384",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "18185",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "27693",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "11588",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BCBS NUMBER",
            "identifier": "82844L",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BCBS NUMBER",
            "identifier": "83590L",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084154602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL AETNA NUMBER",
            "identifier": "5390719",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "00N35N",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BCBS NUMBER",
            "identifier": "83343L",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BCBS NUMBER",
            "identifier": "87190Q",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BCBS NUMBER",
            "identifier": "84347L",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084154601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.