Danielle N Brockelman, | |
185 S Kimball Ave Ste 120, Southlake, TX 76092-1525 | |
(214) 618-0588 | |
Not Available |
Full Name | Danielle N Brockelman |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 185 S Kimball Ave Ste 120, Southlake, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235807066 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 81931 (Texas) | Primary |
Entity Name | Blank Slate Therapy |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1639539364 PECOS PAC ID: 5193069219 Enrollment ID: O20181130000750 |
Mailing Address | Practice Location Address |
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Danielle N Brockelman, 3818 Timberwood Ct, Grand Prairie, TX 75052-6927 Ph: (903) 520-8890 | Danielle N Brockelman, 185 S Kimball Ave Ste 120, Southlake, TX 76092-1525 Ph: (214) 618-0588 |
Caitlyn Mccready, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 558 Silicon Dr Ste 102, Southlake, TX 76092 Phone: 817-415-2155 | |
Melanie Dawn Epp, LPC, LMFT, RPT-S Counselor Medicare: Not Enrolled in Medicare Practice Location: 2485 E Southlake Blvd, 220, Southlake, TX 76092 Phone: 940-594-7474 Fax: 940-321-3920 | |
Catherine Tito, M.A. LPC INTERN Counselor Medicare: Not Enrolled in Medicare Practice Location: 181 Grand Ave, Suite 230, Southlake, TX 76092 Phone: 817-756-1440 | |
Karisha Delvon Richards, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 245 W State Hwy 114, Suite 200, Southlake, TX 76092 Phone: 430-558-1645 | |
Jesse Cole Dawkins, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2435 E Southlake Blvd Ste 100, Southlake, TX 76092 Phone: 817-812-2880 | |
Karen Christensen, LPC, LSOTP Counselor Medicare: Not Enrolled in Medicare Practice Location: 231 E Southlake Blvd Ste 140, Southlake, TX 76092 Phone: 817-228-1336 | |
Andrea Dillow, Counselor Medicare: Not Enrolled in Medicare Practice Location: 558 Silicon Dr Ste 102, Southlake, TX 76092 Phone: 817-415-2155 |