Healthcare Provider Details

I. General information

NPI: 1922736636
Provider Name (Legal Business Name): LEAN ON LOVE PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 WARREN PKWY STE 100
FRISCO TX
75034-9415
US

IV. Provider business mailing address

6160 WARREN PKWY STE 100
FRISCO TX
75034-9415
US

V. Phone/Fax

Practice location:
  • Phone: 469-257-3500
  • Fax:
Mailing address:
  • Phone: 469-257-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: LYNETTE EWUCHIE
Title or Position: PHYSICIAN ASSISTANT
Credential: PA-C
Phone: 469-257-3500