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General NPI Number Information
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NPI Number | 1407295157
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Entity Type | Organization
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Legal Business Name | REDBUD COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 8204 ELMBROOK DR SUITE 305-B
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City | DALLAS
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State | TX
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Zip | 75247-4067
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Country | US
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Telephone | 214-687-8365
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Fax |
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Provider Business Mailing Address
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Address Line | 2233 BISCAYNE DR W
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City | IRVING
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State | TX
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Zip | 75060-7216
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Country | US
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Telephone | 214-687-8365
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | MR. MARK COLLINS
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Credential |
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Telephone | 214-687-8365
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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 | 36594
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License Number State | TX
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