Provider Demographics
| NPI: | 1619011574 |
|---|---|
| Name: | FAMILY SERVICES OF SOUTHEAST TEXAS INC |
| Entity type: | Organization |
| Organization Name: | FAMILY SERVICES OF SOUTHEAST TEXAS INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | BILLING/CREDENTIAL MANAGER |
| Authorized Official - Prefix: | MRS |
| Authorized Official - First Name: | SHIRLEY |
| Authorized Official - Middle Name: | ANN |
| Authorized Official - Last Name: | FIGARI |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 409-833-2668 |
| Mailing Address - Street 1: | 3550 FANNIN ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BEAUMONT |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77701-3805 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 409-833-2668 |
| Mailing Address - Fax: | 409-838-2558 |
| Practice Address - Street 1: | 3550 FANNIN ST |
| Practice Address - Street 2: | |
| Practice Address - City: | BEAUMONT |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77701-3805 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 409-833-2668 |
| Practice Address - Fax: | 409-838-2558 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-02-16 |
| Last Update Date: | 2022-02-08 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Single Specialty |