Provider Demographics
NPI:1699868018
Name:ARMOUR, PHILIP WAYLAND (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:WAYLAND
Last Name:ARMOUR
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2913
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75606-2913
Mailing Address - Country:US
Mailing Address - Phone:903-753-2117
Mailing Address - Fax:903-984-5348
Practice Address - Street 1:409 N FREDONIA ST STE 105
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-6466
Practice Address - Country:US
Practice Address - Phone:903-753-2117
Practice Address - Fax:903-984-5348
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14708101YP2500X
TX106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00223107000OtherMAGELLAN
TX3660LCOtherBCBS-TX
TX119377OtherCHIP