Provider Demographics
NPI:1104599281
Name:DEEDS, ALICE (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:DEEDS
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14101 ELK CANYON RD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79118-1254
Mailing Address - Country:US
Mailing Address - Phone:806-676-1030
Mailing Address - Fax:
Practice Address - Street 1:719 S AUSTIN ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-6714
Practice Address - Country:US
Practice Address - Phone:806-640-4844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85159101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor