Provider Demographics
| NPI: | 1962035386 |
|---|---|
| Name: | LONESTAR SOCIAL SERVICES |
| Entity type: | Organization |
| Organization Name: | LONESTAR SOCIAL SERVICES |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | JAMES |
| Authorized Official - Middle Name: | WAYNE |
| Authorized Official - Last Name: | MERCER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | PHD |
| Authorized Official - Phone: | 512-202-3686 |
| Mailing Address - Street 1: | 302 N HEATHERWILDE BLVD STE 200 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | PFLUGERVILLE |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 78660-3676 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 512-202-3686 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 302 N HEATHERWILDE BLVD STE 200 |
| Practice Address - Street 2: | |
| Practice Address - City: | PFLUGERVILLE |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 78660-3676 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 512-202-3686 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2020-02-13 |
| Last Update Date: | 2020-02-13 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 253J00000X | Agencies | Foster Care Agency | Group - Multi-Specialty | |
| No | 246R00000X | Technologists, Technicians & Other Technical Service Providers | Technician, Pathology | Group - Multi-Specialty | |
| No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
| No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
| No | 103TB0200X | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral | Group - Multi-Specialty |
| No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
| No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family | Group - Multi-Specialty |
| No | 103TF0200X | Behavioral Health & Social Service Providers | Psychologist | Forensic | Group - Multi-Specialty |
| No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
| No | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Multi-Specialty | |
| No | 246RP1900X | Technologists, Technicians & Other Technical Service Providers | Technician, Pathology | Phlebotomy | Group - Multi-Specialty |
| No | 251B00000X | Agencies | Case Management | ||
| No | 252Y00000X | Agencies | Early Intervention Provider Agency | ||
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |