Healthcare Provider Details

I. General information

NPI: 1912502709
Provider Name (Legal Business Name): GREAT LIFE COUNSELING CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3465 NATIONAL DR.
PLANO TX
75025
US

IV. Provider business mailing address

3465 NATIONAL DR STE 215
PLANO TX
75025-1095
US

V. Phone/Fax

Practice location:
  • Phone: 469-665-9445
  • Fax:
Mailing address:
  • Phone: 972-987-5460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN C. LAMBERT
Title or Position: CEO/LICENSED PSYCHOLOGIST
Credential: PSY.D.
Phone: 469-665-9445