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General NPI Number Information
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NPI Number | 1477211514
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Entity Type | Organization
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Legal Business Name | INCLUSIVE THERAPY PLLC
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 12/27/2021
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Provider Practice Location Address
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Address Line | 4760 PRESTON RD STE 244230
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City | FRISCO
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State | TX
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Zip | 75034-8548
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Country | US
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Telephone | 469-626-7914
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Fax |
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Provider Business Mailing Address
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Address Line | 4760 PRESTON RD STE 244230
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City | FRISCO
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State | TX
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Zip | 75034-8548
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Country | US
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Telephone | 469-626-7914
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Fax |
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Authorized Official
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Title or Position | THERAPIST, MANAGING MEMBER
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Name | JASMINE RICKS
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Credential | MA, LMFT, LPC
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Telephone | 469-626-7914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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