Healthcare Provider Details

I. General information

NPI: 1275183733
Provider Name (Legal Business Name): DANDELION COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2019
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S COMMERCE ST
CENTERVILLE TX
75833-1965
US

IV. Provider business mailing address

PO BOX 855
CENTERVILLE TX
75833-0855
US

V. Phone/Fax

Practice location:
  • Phone: 903-536-3697
  • Fax:
Mailing address:
  • Phone: 903-536-3697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: KELLI KNIGHT FRANKLIN
Title or Position: OWNER
Credential: LPC, LCDC
Phone: 903-536-3697