Healthcare Provider Details

I. General information

NPI: 1568302289
Provider Name (Legal Business Name): CHAOS CONSULTING & THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3018 PINYON PL
MELISSA TX
75454-0135
US

IV. Provider business mailing address

6723 UMPHRESS RD
DALLAS TX
75217-1269
US

V. Phone/Fax

Practice location:
  • Phone: 469-531-7039
  • Fax:
Mailing address:
  • Phone: 469-531-7039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: KENDRICK RESENDIZ
Title or Position: CHAOS COORDINATOR
Credential:
Phone: 469-531-7039