Provider Demographics
NPI:1316795495
Name:PSYCHOTHERAPY IN THE WOODS
Entity type:Organization
Organization Name:PSYCHOTHERAPY IN THE WOODS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN L. REAGAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:REAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-431-0724
Mailing Address - Street 1:2121 HIDDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PIPE CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:78063-6153
Mailing Address - Country:US
Mailing Address - Phone:830-431-0724
Mailing Address - Fax:
Practice Address - Street 1:2121 HIDDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:PIPE CREEK
Practice Address - State:TX
Practice Address - Zip Code:78063-6153
Practice Address - Country:US
Practice Address - Phone:830-431-0724
Practice Address - Fax:210-229-8907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty