ALLEGIANCE MENTAL HEALTH & WELLNESS SERVICES LLC — NPI 1760107387 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1760107387

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

1041C0700X (CMS 80)

Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical

Box 32 Service Location & ZIP+4

605 AUSTIN AVE, WACO, TX, 76701-2048

✓ 9-Digit EDI 837 ZIP+4 (76701-2048)

Practice Phone & Referral Fax

(254) 900-7986

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1760107387 (ALLEGIANCE MENTAL HEALTH & WELLNESS SERVICES LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1760107387` (NPI-2 Organization / Facility)
Provider / Legal Name	ALLEGIANCE MENTAL HEALTH & WELLNESS SERVICES LLC
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical NUCC Code: `1041C0700X` (Social Worker, Clinical)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	605 AUSTIN AVE, WACO, TX, 76701-2048
Practice Telephone / Fax	Tel: (254) 900-7986
Administrative Mailing Address	605 AUSTIN AVE, WACO, TX, 76701-2048
Enumeration & Last Sync	Enumerated: 2022-10-06 \| CMS Record Updated: 2025-03-21
Authorized Official	THEOPHLIUS WATSON (Managing Member)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

605 AUSTIN AVE, WACO, TX, 76701-2048

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Plain-English Taxonomy & CMS Crosswalk (1041C0700X)

What Does Taxonomy Code 1041C0700X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1041C0700X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 80 (Licensed Clinical Social Worker)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Social Worker, Clinical for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ALLEGIANCE MENTAL HEALTH & WELLNESS SERVICES LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101YM0800X` — Counselor, Mental Health Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: N/A \| License: `Verified` \| Primary: Secondary
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: N/A \| License: `Verified` \| Primary: Secondary
`103TC0700X` — Psychologist, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical	State: N/A \| License: `Verified` \| Primary: Secondary
`104100000X` — Social Worker Plain English: Licensed & Credentialed Social Worker	State: N/A \| License: `Verified` \| Primary: Secondary
`1041C0700X` — Social Worker, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical	State: N/A \| License: `Verified` \| Primary: Yes (Primary)
`106H00000X` — Marriage & Family Therapist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist	State: N/A \| License: `Verified` \| Primary: Secondary
`106S00000X` — Behavior Technician Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Technician	State: N/A \| License: `Verified` \| Primary: Secondary
`163W00000X` — Registered Nurse Plain English: Licensed & Credentialed Registered Nurse	State: N/A \| License: `Verified` \| Primary: Secondary
`171400000X` — Health & Wellness Coach Plain English: Licensed & Credentialed Health & Wellness Coach	State: N/A \| License: `Verified` \| Primary: Secondary
`2084P0800X` — Psychiatry & Neurology, Psychiatry Plain English: Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician)	State: N/A \| License: `Verified` \| Primary: Secondary
`363L00000X` — Nurse Practitioner Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner	State: N/A \| License: `Verified` \| Primary: Secondary
`363LP0808X` — Nurse Practitioner, Psych/Mental Health Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health	State: N/A \| License: `Verified` \| Primary: Secondary
`390200000X` — Student in an Organized Health Care Education/Training Program Plain English: Licensed & Credentialed Student in an Organized Health Care Education/Training Program	State: N/A \| License: `Verified` \| Primary: Secondary

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ALLEGIANCE MENTAL HEALTH & WELLNESS SERVICES LLC (NPI #1760107387)