Healthcare Provider Details

I. General information

NPI: 1659979466
Provider Name (Legal Business Name): MINA ASHFOUR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 HORSESHOE BND
FAIRVIEW TX
75069-8700
US

IV. Provider business mailing address

120 HORSESHOE BND
FAIRVIEW TX
75069-8700
US

V. Phone/Fax

Practice location:
  • Phone: 214-544-1153
  • Fax:
Mailing address:
  • Phone: 214-544-1153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number95093
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: