Provider Demographics
NPI:1215680657
Name:THE AMOXIE EDUCATIONAL CONSULTING GROUP LLC
Entity type:Organization
Organization Name:THE AMOXIE EDUCATIONAL CONSULTING GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EDUCATION OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:AKWETA
Authorized Official - Middle Name:
Authorized Official - Last Name:E HICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-706-4652
Mailing Address - Street 1:900 N WALNUT CREEK DR
Mailing Address - Street 2:STE 100-PMB 394
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063
Mailing Address - Country:US
Mailing Address - Phone:817-706-4652
Mailing Address - Fax:
Practice Address - Street 1:705 ACADIA ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-4104
Practice Address - Country:US
Practice Address - Phone:817-706-4652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle