Lake Shore Center for Psychological Services, P.c.

NPI #1467599779 in Waco, Texas

Provider Information

NPI Number: 1467599779
Entity Type: Organization
Organization Name: Lake Shore Center for Psychological Services, P.c.
Primary Specialty: Psychologist - Clinical
Enumeration Date: Jan 30, 2007
Last Updated: Jan 5, 2011

Practice Location

Address: 4555 LAKE SHORE DR
City: Waco
State: Texas
ZIP Code: 76710-1814
Phone: (254) 776-0400

Authorized Official

Name: HAROLD H LECRONE JR., PH.D.
Title: EXECUTIVE DIRECTOR
Phone: (254) 776-0400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X
Psychologist	103T00000X
Psychologist - Clinical — Clinical	103TC0700X	Primary

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