Provider Demographics
NPI:1215155528
Name:H.E.B. PSYCHOLOGICAL ASSOCIATES P.C.
Entity type:Organization
Organization Name:H.E.B. PSYCHOLOGICAL ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:CELAYA-FORBES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:817-282-3323
Mailing Address - Street 1:1245 SOUTHRIDGE CT STE 100
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-4390
Mailing Address - Country:US
Mailing Address - Phone:817-282-3323
Mailing Address - Fax:817-282-6128
Practice Address - Street 1:1245 SOUTHRIDGE CT STE 100
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-4390
Practice Address - Country:US
Practice Address - Phone:817-282-3323
Practice Address - Fax:817-282-6128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX04377101YP2500X
TX11248101YP2500X
TX2-3673103TC0700X
TX23661103TC0700X
TX32477103TC0700X
TX03339106H00000X
TX2773106H00000X
TX2793106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N60FMedicare ID - Type UnspecifiedPSYCHOLOGY