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General NPI Number Information
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NPI Number | 1144624123
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Entity Type | Individual
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Provider Name | CHIANTI MINGO LPC
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Gender | Female
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Dates
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Enumeration Date | 10/20/2014
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 3560 W CAMP WISDOM RD STE 100
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City | DALLAS
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State | TX
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Zip | 75237-2506
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Country | US
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Telephone | 214-266-1280
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Fax |
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Provider Business Mailing Address
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Address Line | 7575 S WESTMORELAND RD APT 1936
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City | DALLAS
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State | TX
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Zip | 75237-3332
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Country | US
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Telephone | 716-529-9303
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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 | 005352
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License Number State | NY
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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 | 88417
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License Number State | TX
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