Pelican Bayou Counseling Agency-texas | |
1111 W Mockingbird Ln Ste 7-2 Dallas TX 75247-5028 | |
(318) 861-8938 | |
Not Available |
Full Name | Pelican Bayou Counseling Agency-texas |
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Speciality | Community/behavioral Health |
Location | 1111 W Mockingbird Ln Ste 7-2, Dallas, Texas |
Authorized Official Name and Position | Brittney Jewitt (CEO) |
Authorized Official Contact | 3184701632 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pelican Bayou Counseling Agency-texas 9403 Mansfield Rd Shreveport LA 71118-3815 Ph: (318) 861-8938 | Pelican Bayou Counseling Agency-texas 1111 W Mockingbird Ln Ste 7-2 Dallas TX 75247-5028 Ph: (318) 861-8938 |
NPI Number | 1578169306 |
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Provider Enumeration Date | 12/08/2020 |
Last Update Date | 12/15/2020 |
Certification Date | 12/15/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578169306 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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