| Counselorheidi, Llc | |
|
17734 Preston Rd Ste 201 Dallas TX 75252-5725 | |
| (469) 955-6579 | |
| Not Available |
| Full Name | Counselorheidi, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 17734 Preston Rd Ste 201, Dallas, Texas |
| Authorized Official Name and Position | Heidi L. Southern (SOLE MEMBER/LPC) |
| Authorized Official Contact | 4699556579 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Counselorheidi, Llc 18331 Roehampton Dr Apt 112 Dallas TX 75252-5139 Ph: (469) 955-6579 | Counselorheidi, Llc 17734 Preston Rd Ste 201 Dallas TX 75252-5725 Ph: (469) 955-6579 |
| NPI Number | 1285273946 |
|---|---|
| Provider Enumeration Date | 12/30/2019 |
| Last Update Date | 12/30/2019 |
| Certification Date | 12/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285273946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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