MEDICARE: PROVISIONS CONSULTING 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	101YP2500X	Professional Counselor	10397	TX

General Provider Information

NPI Number	:	1952408866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROVISIONS CONSULTING INC

Provider Business Mailing Address
First Line	:	6370 LBJ FREEWAY
Second Line	:	STE 272
City	:	DALLAS
State	:	TX
Zip	:	75240-6419
Country	:	US
Telephone Number	:	972-385-6400
Fax Number	:	972-385-3907

Provider Business Practice Location Address
First Line	:	6370 LBJ FREEWAY
Second Line	:	STE 272
City	:	DALLAS
State	:	TX
Zip	:	75240-6419
Country	:	US
Telephone Number	:	972-385-6400
Fax Number	:	972-385-3907

Authorized Official
Title or Position	:	OWNER
Name	:	MS. SARAH J KOVICH
Credential	:	MED LPC
Telephone Number	:	972-385-6400

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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Directions to “PROVISIONS CONSULTING INC ” Practice Location

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