Healthcare Provider Details

I. General information

NPI: 1073783148
Provider Name (Legal Business Name): GEARING UP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 COIT RD SUITE B
PLANO TX
75075-3758
US

IV. Provider business mailing address

2415 COIT RD SUITE B
PLANO TX
75075-3758
US

V. Phone/Fax

Practice location:
  • Phone: 972-596-7229
  • Fax: 972-596-7410
Mailing address:
  • Phone: 972-596-7229
  • Fax: 972-596-7410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MILTON LEROY GEARING
Title or Position: PSHCHOLOGIST
Credential: PHD
Phone: 972-596-7229