Mark Ambrosious, COUNSELOR INTERN
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Longview, TX
NPI 1811268485 · NPPES record last updated Jan 13, 2012
Key facts
- NPI
- 1811268485
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 6598 (TX)
- Practice address
- 950 N 4TH St
Longview, TX 75601-5436 - Phone
- (903) 758-0596
- NPI assigned
- Jan 13, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6598 | TX | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 6598 | TX | Yes |
Addresses
Primary practice location
950 N 4TH St
Longview, TX 75601-5436
Mailing address
PO Box 6800
Longview, TX 75608-6800
Phone (903) 758-2471
Other providers in Longview, TX
- Alto Behavioral Health Services PLLC
- Altus Hospice of Longview, LP
- Nnamdi Amachukwu
- Natasha Amador
- Amazing Living HCS, LLC
- American Current Care P.a.
- American Habilitation Services, Inc
- American Homepatient, Inc.
- American Recovery Clinic LLC
- Krishan Amin
All providers in Longview, TX · Addiction (Substance Use Disorder) Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.