Healthcare Provider Details

I. General information

NPI: 1861669590
Provider Name (Legal Business Name): EDWARD E LAYMANCE PHD, LPC,LMFT, BCPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2912 LITTLE RD
ARLINGTON TX
76016-1725
US

IV. Provider business mailing address

2912 LITTLE RD
ARLINGTON TX
76016-1725
US

V. Phone/Fax

Practice location:
  • Phone: 817-457-6728
  • Fax: 817-451-7732
Mailing address:
  • Phone: 817-457-6728
  • Fax: 817-451-7732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7565
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number3539
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: