=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396411526
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANNY LEE MULNIX LPC ASSOCIATE
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2021
-----------------------------------------------------
Last Update Date | 08/18/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2727 LYNDON B JOHNSON FWY STE 406
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75234-7339
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-842-0001
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 207 WAKE DR APT SUITE
-----------------------------------------------------
City | RICHARDSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75081-3642
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-663-2809
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 85299
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------