Individual provider · Type 1 NPI
Geraci Mack, LBSW, MHA, CHAPLAIN
Public Health or Welfare Agency · Gladewater, TX
NPI number
1487209003
Active
Practice location
408 W Upshur Ave
Gladewater, TX 75647-2124
Other practice locations
- 15995 FM 2493, Tyler, TX 75703-7564 · (903) 918-8152
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | None listed |
| Mental Health Counselor | 101YM0800X | None listed |
| Pastoral Counselor | 101YP1600X | None listed |
| Social Worker | 104100000X | 26197 (TX) |
| Community/Behavioral Health Agency | 251S00000X | None listed |
| Public Health or Welfare Agency Primary | 251K00000X | None listed |
Public Health or Welfare Agency: Definition to come...
Another provider at this address
About NPI 1487209003
Geraci Mack, LBSW, MHA, CHAPLAIN's National Provider Identifier is 1487209003, issued on Aug 9, 2019. The primary taxonomy on file is Public Health or Welfare Agency (251K00000X), and the practice location is in Gladewater, TX. The record was last updated on Aug 9, 2019.