DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: PEACEFUL ROOTS THERAPY PLLC

MEDICARE: PEACEFUL ROOTS THERAPY PLLC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1598613762
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEACEFUL ROOTS THERAPY PLLC
Provider Business Mailing Address
First Line : 3626 N HALL ST STE 610
Second Line :
City : DALLAS
State : TX
Zip : 75219-5131
Country : US
Telephone Number : 469-554-0364
Fax Number :
Provider Business Practice Location Address
First Line : 3626 N HALL ST STE 610
Second Line :
City : DALLAS
State : TX
Zip : 75219-5131
Country : US
Telephone Number : 469-554-0364
Fax Number :
Authorized Official
Title or Position : THERAPIST
Name : OLIVIA CANNON
Credential : LMSW
Telephone Number : 469-554-0364
Provider Enumeration Date : 03/21/2026
Last Update Date : 03/21/2026

Similar Medicare Providers

1699623850 — OLIVIA CANNON LMSW
Practice Location Address:
3626 N HALL ST STE 610
DALLAS, TX
75219-5131
Practice Phone: 469-554-0364
Practice Fax:
1992275770 — NIKIA A AUTRY
Practice Location Address:
3626 N HALL ST STE 610
DALLAS, TX
75219-5131
Practice Phone: 866-301-1456
Practice Fax:
1518639244 — AIM OF TEXAS LLC
Practice Location Address:
3626 N HALL ST STE 610
DALLAS, TX
75219-5131
Practice Phone: 757-790-0116
Practice Fax:
1508505710 — ETCHED QUALITY CARE ,LLC
Practice Location Address:
3626 N HALL ST STE 610
DALLAS, TX
75219-5131
Practice Phone: 214-584-7077
Practice Fax:
1437877362 — LEE JACKSON ENTERPRISES
Practice Location Address:
3626 N HALL ST STE 610
DALLAS, TX
75219-5131
Practice Phone: 866-301-1456
Practice Fax: 469-898-6344
1295502656 — AAA BEHAVIORAL HEALTH
Practice Location Address:
3626 N HALL ST STE 610
DALLAS, TX
75219-5131
Practice Phone: 214-646-0001
Practice Fax: 214-646-0004

Directions to “PEACEFUL ROOTS THERAPY PLLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.