Healthcare Provider Details

I. General information

NPI: 1972467926
Provider Name (Legal Business Name): HOMEROOM COUNSELING: TEEN FIRST THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6370 LYNDON B JOHNSON FWY STE 274
DALLAS TX
75240-6436
US

IV. Provider business mailing address

2201 WOLF ST APT 3103
DALLAS TX
75201-1126
US

V. Phone/Fax

Practice location:
  • Phone: 208-407-9063
  • Fax:
Mailing address:
  • Phone: 208-407-9063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEANNE FOELL
Title or Position: ADOLESCENT MENTAL HEALTH THERAPIST
Credential: LCSW
Phone: 208-407-9063