Healthcare Provider Details

I. General information

NPI: 1700583390
Provider Name (Legal Business Name): TENLEY GUMMELT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6275 W PLANO PKWY STE 500
PLANO TX
75093-4942
US

IV. Provider business mailing address

6275 W PLANO PKWY STE 500
PLANO TX
75093-4942
US

V. Phone/Fax

Practice location:
  • Phone: 469-269-5467
  • Fax:
Mailing address:
  • Phone: 469-269-5467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number78430
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number78430
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: