Provider Demographics
NPI:1316909799
Name:SAMARITAN COUNSELING CENTER OF SOUTHEAST TEXAS
Entity type:Organization
Organization Name:SAMARITAN COUNSELING CENTER OF SOUTHEAST TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCCUTCHEON
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:409-727-6400
Mailing Address - Street 1:7980 ANCHOR DR BLDG 500
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-8285
Mailing Address - Country:US
Mailing Address - Phone:409-727-6400
Mailing Address - Fax:409-727-6403
Practice Address - Street 1:7980 ANCHOR DR BLDG 500
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-8285
Practice Address - Country:US
Practice Address - Phone:409-727-6400
Practice Address - Fax:409-727-6403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150454002Medicaid
TX348535-000OtherMAGELLAN
TX0033GZOtherBCBS OF TEXAS
TX0033GZOtherBCBS OF TEXAS