Healthcare Provider Details

I. General information

NPI: 1427581396
Provider Name (Legal Business Name): ERIC RYAN FLYG M.A., LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2017
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 HERITAGE DR
MCKINNEY TX
75069-3256
US

IV. Provider business mailing address

4409 LONGFELLOW DR
PLANO TX
75093-3220
US

V. Phone/Fax

Practice location:
  • Phone: 972-422-5939
  • Fax:
Mailing address:
  • Phone: 214-417-5782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number72981
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: