MEDICARE: AARON'S COUNSELING INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	8205	TX
2	101YP2500X	Professional Counselor	72908	TX

General Provider Information

NPI Number	:	1063864221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AARON'S COUNSELING INC.

Provider Business Mailing Address
First Line	:	4549 WESTMORELAND
Second Line	:	SUITE 1A
City	:	DALLAS
State	:	TX
Zip	:	75237
Country	:	US
Telephone Number	:	214-206-6912
Fax Number	:

Provider Business Practice Location Address
First Line	:	4549 S WESTMORELAND RD
Second Line	:	SUITE 1A
City	:	DALLAS
State	:	TX
Zip	:	75237-1015
Country	:	US
Telephone Number	:	214-206-6912
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. PHILLIP DWIGHT ANTHONY
Credential	:	LPC, LCDC
Telephone Number	:	214-206-6912

Provider Enumeration Date	:	07/12/2016
Last Update Date	:	07/12/2016

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