| Rebirth Counseling, Pllc | |
|
1100 Stone Rd Ste 103 Kilgore TX 75662-5494 | |
| (469) 608-0295 | |
| (903) 913-7274 |
| Full Name | Rebirth Counseling, Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1100 Stone Rd Ste 103, Kilgore, Texas |
| Authorized Official Name and Position | Crystal Dionne Dudley (OWNER) |
| Authorized Official Contact | 4696080295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rebirth Counseling, Pllc 1100 Stone Rd Ste 103 Kilgore TX 75662-5494 Ph: (469) 608-0295 | Rebirth Counseling, Pllc 1100 Stone Rd Ste 103 Kilgore TX 75662-5494 Ph: (469) 608-0295 |
| NPI Number | 1255971958 |
|---|---|
| Provider Enumeration Date | 01/10/2020 |
| Last Update Date | 01/10/2020 |
| Certification Date | 01/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255971958 | NPI | - | NPPES |
| 3921009-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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