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Provider Information for 1851437883


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Dr. JAMES P FLORENCE LPC


Sex: Male

NPI: 1851437883
Last Updated: 2007-07-08
Certification Date:

Details

NameValue
NPI1851437883
Enumeration Date2007-01-29
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 407 E MARSHALL AVE
LONGVIEW, TX 75601-5423
United States

Phone: 903-236-4577 | Fax:903-236-0246
 
Primary Practice Address 407 E MARSHALL AVE
WILLOW BEND CENTER
LONGVIEW, TX 75601-5423
United States

Phone: 903-236-4577 | Fax:903-236-0246
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDTX095893604
Other (non-Medicare)TX827701Blue Cross Blue Shield
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalTX14876