=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164630562
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEIGHBORHOOD YOUTH AND FAMILY COUNSELING OF RICHARDSON, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 312 E TYLER ST
-----------------------------------------------------
City | RICHARDSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75081-6041
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-744-4858
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 831078
-----------------------------------------------------
City | RICHARDSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75083-1078
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-744-4858
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MS. SHARON ALLRED
-----------------------------------------------------
Credential | M.ED.
-----------------------------------------------------
Telephone | 972-744-4858
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------