Provider Demographics
NPI: | 1609243302 |
---|---|
Name: | MCPHERSON COUNSELING, PLLC |
Entity type: | Organization |
Organization Name: | MCPHERSON COUNSELING, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CAROL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MCPHERSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC-S |
Authorized Official - Phone: | 817-800-0520 |
Mailing Address - Street 1: | 204 EAGLE CT |
Mailing Address - Street 2: | |
Mailing Address - City: | BEDFORD |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 76021-3216 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 817-800-0520 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1431 GREENWAY DR |
Practice Address - Street 2: | SUITE 800 |
Practice Address - City: | IRVING |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75038-2448 |
Practice Address - Country: | US |
Practice Address - Phone: | 972-870-4446 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-08-28 |
Last Update Date: | 2015-08-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 61534 | 101YP2500X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Single Specialty |