Healthcare Provider Details

I. General information

NPI: 1841465432
Provider Name (Legal Business Name): TINA MCCARDELL TAYLOR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 FULTON ST STE 402
DENTON TX
76201-2661
US

IV. Provider business mailing address

2908 OSAGE LN
DENTON TX
76210-2959
US

V. Phone/Fax

Practice location:
  • Phone: 940-382-5328
  • Fax: 940-898-8527
Mailing address:
  • Phone: 940-387-1869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number61266
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: