Healthcare Provider Details

I. General information

NPI: 1902158470
Provider Name (Legal Business Name): LAUREN VAKOS LMFT, ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2012
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 W MOCKINGBIRD LN STE 500E
DALLAS TX
75247-4937
US

IV. Provider business mailing address

7308 ALMA DR
PLANO TX
75025-3568
US

V. Phone/Fax

Practice location:
  • Phone: 214-456-8899
  • Fax:
Mailing address:
  • Phone: 972-422-5939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number202606
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: