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General NPI Number Information
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NPI Number | 1316535495
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Entity Type | Organization
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Legal Business Name | KAIROS COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 01/05/2021
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 101 E PARK BLVD STE 600
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City | PLANO
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State | TX
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Zip | 75074-8818
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Country | US
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Telephone | 469-592-1349
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Fax |
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Provider Business Mailing Address
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Address Line | 1806 WILLOW CREEK CT
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City | GARLAND
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State | TX
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Zip | 75040-3968
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Country | US
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Telephone | 972-953-6585
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | AKISHA SIMON
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Credential | LPC
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Telephone | 972-953-6585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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