Provider Demographics
NPI: | 1235788563 |
---|---|
Name: | REYNOLDS COUNSELING SERVICES, PLLC |
Entity type: | Organization |
Organization Name: | REYNOLDS COUNSELING SERVICES, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | LICENSED PROFESSIONAL COUNSELOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | VERDA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LAWSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 214-509-8907 |
Mailing Address - Street 1: | 609 CRAZY HORSE DR |
Mailing Address - Street 2: | |
Mailing Address - City: | AUBREY |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 76227-1406 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 214-509-8907 |
Mailing Address - Fax: | 972-704-3442 |
Practice Address - Street 1: | 600 S DENTON TAP RD STE 100 |
Practice Address - Street 2: | |
Practice Address - City: | COPPELL |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75019-4551 |
Practice Address - Country: | US |
Practice Address - Phone: | 214-509-8907 |
Practice Address - Fax: | 972-704-3442 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-09-09 |
Last Update Date: | 2023-09-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Single Specialty |