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General NPI Number Information
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NPI Number | 1306334461
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Entity Type | Organization
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Legal Business Name | LOLABODE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 04/24/2018
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 214 SOUTH MAIN STREET SUITE 208
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City | DUNCANVILLE
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State | TX
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Zip | 75116
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Country | US
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Telephone | 214-580-6059
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Fax |
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Provider Business Mailing Address
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Address Line | 214 SOUTH MAIN STREET SUITE 208
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City | DUNCANVILLE
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State | TX
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Zip | 75116
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Country | US
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Telephone | 214-580-6059
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/DIRECTOR
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Name | GRACE DAVID
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Credential | LPC
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Telephone | 214-580-6059
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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 | 75141
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License Number State | TX
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