MANAGING LIFE MENTAL HEALTH CLINIC LLC (NPI# 1932706512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932706512 |
Entity Type | Organization |
Organization Name | MANAGING LIFE MENTAL HEALTH CLINIC LLC |
Practice Address |
2708 Dayton Ave Wichita Falls TX 76301-6110 |
Mailing Address |
4860 Rhea Road Wichita Falls TX 76308-4404 |
Practice Telephone | 9402762400 |
Practice Fax Number | 9402762403 |
Mailing Telephone | 9402762400 |
Mailing Fax Number | 9402762403 |
Enumeration Date | 2020-10-06 |
Last Update Date | 2020-10-06 |
Authorized Official Name | DIANE SHEREE EAKINS (PMHNP) |
Authorized Official Telephone | 9406311141 |
Authorized Official Credential | APRN |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
Street Address |
2708 DAYTON AVE |
City | WICHITA FALLS |
State | TX |
Zip Code | 76301-6110 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679192991 | Rebecca Ashley Marin | Licensed Vocational Nurse | 909 8th Sreet, Ste 100, Wichita Falls, TX 76301 | 2020-04-16 |
1164077558 | Melissa Ann Marshall | Registered Nurse | 1717 Lucile Ave, Wichita Falls, TX 76301 | 2019-08-02 |
1841760659 | Edward Scott Hamilton | Psychologist | 710 Lamar St., Wichita Falls, TX 76301 | 2018-12-05 |
1457872681 | Jennyfer A Rosado | Counselor | 719 Scott Ave Ste 610, Wichita Falls, TX 76301 | 2017-06-28 |
1023547676 | Cale David Lennard | Dentist | 2405 9th St Ste A, Wichita Falls, TX 76301 | 2017-06-07 |
1790198455 | Tongle Yu | Family Medicine | 1301 Third St, Suite 200, Wichita Falls, TX 76301 | 2014-06-10 |
1821412081 | Jennifer Burbage | Nurse Practitioner | 1700 3rd Street, Wichita Falls, TX 76301 | 2014-02-09 |
1275871568 | Jeffrey John Papak | Pharmacy Technician | 1610 9th Street, Wichita Falls, TX 76301 | 2013-01-22 |
1679826853 | Cheryl Denise Williams | Clinical Nurse Specialist | 1605 10th Street, Wichita Falls, TX 76301 | 2012-10-24 |
1902199250 | Tilahun Worku Belay | Internal Medicine | 1631 11th St Unit B, Wichita Falls, TX 76301 | 2011-05-19 |
Find all providers in zip 76301 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467078634 | Jennyfer Rosado, Pllc | Counselor | 710 Lamar St Ste 440i, Wichita Falls, TX 76301-6837 | 2020-06-23 |
1447809330 | Patrick Vincent Coyle | Counselor | 4500 Barbados, Wichita Falls, TX 76308-4931 | 2019-09-04 |
1457872681 | Jennyfer A Rosado | Counselor | 719 Scott Ave Ste 610, Wichita Falls, TX 76301 | 2017-06-28 |
1326303439 | Soulquest | Counselor | 2407 Kemp Blvd, Suite B, Wichita Falls, TX 76309-5353 | 2012-07-05 |
1679871248 | Rochelle Diane Granbery | Counselor | 3209 Cuba Ct, Wichita Falls, TX 76309-2024 | 2011-03-07 |
1326191784 | Madalyne Marie Allen | Counselor | 2301 Kell Blvd, Suite 215, Wichita Falls, TX 76308-1007 | 2007-01-19 |
1740344126 | Ron Lee Burks | Counselor | 710 Denver St, Wichita Falls, TX 76301-4140 | 2006-12-20 |
1871666842 | Diane Johnson Boddy | Counselor | 1401 Holliday St Ste 218, Wichita Falls, TX 76301-7143 | 2006-11-16 |
1376644914 | Kay L Story | Counselor | 2910 Kemp Blvd Ste 205, Wichita Falls, TX 76308-1050 | 2006-09-26 |
1942810262 | Melissa Nelson | Counselor | 1106 Travis St, Wichita Falls, TX 76301-4676 | 2020-08-02 |
Find all providers in WICHITA FALLS |
City | WICHITA FALLS |
Zip Code | 76301 |
Please comment or provide details below to improve the information on MANAGING LIFE MENTAL HEALTH CLINIC LLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.