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General NPI Number Information
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NPI Number | 1245828797
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Entity Type | Organization
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Legal Business Name | START LOVING YOURSELF WELL COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 01/08/2021
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Provider Practice Location Address
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Address Line | 2025 W WHEATLAND RD
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City | DALLAS
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State | TX
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Zip | 75232-4516
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Country | US
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Telephone | 972-224-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 828 TIMBER DELL LN
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City | DALLAS
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State | TX
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Zip | 75232-2046
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Country | US
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Telephone | 469-744-2693
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. KIMBERLY LAVERN PEARSON
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Credential | M.ED, LPC
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Telephone | 469-744-2693
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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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