| Lost Stories Counseling Services Pllc | |
|
8604 Greenville Ave Ste 201 Dallas TX 75243-7148 | |
| (469) 834-5115 | |
| Not Available |
| Full Name | Lost Stories Counseling Services Pllc |
|---|---|
| Speciality | Counselor |
| Location | 8604 Greenville Ave Ste 201, Dallas, Texas |
| Authorized Official Name and Position | Blane Brazier (OWNER) |
| Authorized Official Contact | 4698345115 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lost Stories Counseling Services Pllc 1808 Serenade Ln Richardson TX 75081-4763 Ph: () - | Lost Stories Counseling Services Pllc 8604 Greenville Ave Ste 201 Dallas TX 75243-7148 Ph: (469) 834-5115 |
| NPI Number | 1417733692 |
|---|---|
| Provider Enumeration Date | 09/05/2023 |
| Last Update Date | 12/04/2023 |
| Certification Date | 12/04/2023 |
| Medicare PECOS PAC ID | 4486002904 |
|---|---|
| Medicare Enrollment ID | O20231122000579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417733692 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Blane Brazier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790475705 PECOS PAC ID: 0749638260 Enrollment ID: I20231122001217 |
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