Provider Demographics
NPI:1871513853
Name:TOWNSEND, WARREN TERRY (MA, LCSW)
Entity type:Individual
Prefix:MR
First Name:WARREN
Middle Name:TERRY
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 E CENTRAL TEXAS EXPY
Mailing Address - Street 2:STE. 103
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-9166
Mailing Address - Country:US
Mailing Address - Phone:254-526-7272
Mailing Address - Fax:254-526-3949
Practice Address - Street 1:1711 E CENTRAL TEXAS EXPY
Practice Address - Street 2:STE. 103
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-9166
Practice Address - Country:US
Practice Address - Phone:254-526-7272
Practice Address - Fax:254-526-3949
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX014161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX108275202Medicaid
TX00S80HMedicare ID - Type Unspecified