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General NPI Number Information
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NPI Number | 1275142739
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Entity Type | Organization
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Legal Business Name | 92 REASONS
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Dates
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Enumeration Date | 07/30/2020
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Last Update Date | 07/30/2020
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Provider Practice Location Address
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Address Line | 1332 TEASLEY LN STE 103A
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City | DENTON
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State | TX
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Zip | 76205-7946
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Country | US
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Telephone | 469-986-9629
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 LAKE HOLLOW DR
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City | LITTLE ELM
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State | TX
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Zip | 75068-8411
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Country | US
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Telephone | 469-986-9629
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Fax | 469-453-3193
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Authorized Official
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Title or Position | DIRECTR OF CLINICAL SERVICES
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Name | SOPHIA CANNON
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Credential | MCRC, CRC, LPC
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Telephone | 469-986-9629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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