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General NPI Number Information
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NPI Number | 1083497291
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Entity Type | Organization
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Legal Business Name | ERICA WOODALL COUNSELING, PLLC
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 3020 BROADMOOR LN STE 200
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City | FLOWER MOUND
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State | TX
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Zip | 75022-2705
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Country | US
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Telephone | 940-331-0505
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Fax |
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Provider Business Mailing Address
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Address Line | 3020 BROADMOOR LN STE 200
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City | FLOWER MOUND
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State | TX
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Zip | 75022-2705
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Country | US
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Telephone | 940-331-0505
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Fax |
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Authorized Official
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Title or Position | THERAPIST/CLINICAL SOCIAL WORKER
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Name | ERICA WOODALL
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Credential | LCSW
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Telephone | 940-594-6545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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