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General NPI Number Information
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NPI Number | 1053958686
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Entity Type | Organization
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Legal Business Name | BEAUTIFUL MINDS COUNSELING
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Dates
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Enumeration Date | 12/02/2019
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Last Update Date | 12/02/2019
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Provider Practice Location Address
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Address Line | 2311 MUSTANG DR STE 300
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City | GRAPEVINE
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State | TX
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Zip | 76051-1010
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Country | US
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Telephone | 469-844-1216
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Fax | 219-736-3896
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Provider Business Mailing Address
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Address Line | PO BOX 140982
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City | IRVING
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State | TX
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Zip | 75014-0982
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | PAMELA SMITH
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Credential | LPC
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Telephone | 469-844-1216
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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 |
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License Number State |
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