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General NPI Number Information
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NPI Number | 1003479239
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Entity Type | Individual
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Provider Name | TY A ALLISON LPC, NCC
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Gender | Male
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Dates
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Enumeration Date | 04/14/2019
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Last Update Date | 04/14/2019
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Provider Practice Location Address
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Address Line | 3500 OAK LAWN AVE STE 230
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City | DALLAS
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State | TX
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Zip | 75219-4369
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Country | US
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Telephone | 817-689-5451
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Fax |
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Provider Business Mailing Address
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Address Line | 8594 HANFORD DR
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City | DALLAS
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State | TX
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Zip | 75243-6412
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Country | US
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Telephone | 817-689-5451
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 70250
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 70250
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 70250
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License Number State | TX
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