Healthcare Provider Details

I. General information

NPI: 1124480892
Provider Name (Legal Business Name): IJEOMA ONYEJIAKA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8035 E R L THORNTON FWY STE 512
DALLAS TX
75228-7022
US

IV. Provider business mailing address

8035 E R L THORNTON FWY STE 512
DALLAS TX
75228-7022
US

V. Phone/Fax

Practice location:
  • Phone: 972-400-2246
  • Fax: 800-216-4791
Mailing address:
  • Phone: 972-400-2246
  • Fax: 800-216-4791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number72670
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number72670
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number72670
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: