MEDICARE: SECRET GARDEN VIBES LLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1720961758
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SECRET GARDEN VIBES LLC

Provider Business Mailing Address
First Line	:	3732 REDSTONE DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76001-6512
Country	:	US
Telephone Number	:	214-413-9181
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 W PARK ROW DR
Second Line	:
City	:	PANTEGO
State	:	TX
Zip	:	76013-2049
Country	:	US
Telephone Number	:	214-413-9181
Fax Number	:

Authorized Official
Title or Position	:	LPC
Name	:	PRISHNA JIMENEZ-CASSAN
Credential	:	M.ED.
Telephone Number	:	214-413-9181

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	08/04/2025

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Directions to “SECRET GARDEN VIBES LLC ” Practice Location

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