=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508772435
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HOLLY KURISKY
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2026
-----------------------------------------------------
Last Update Date | 08/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4125 FAIRWAY DR STE 130
-----------------------------------------------------
City | CARROLLTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75010-4161
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-885-1222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1604 ELMEN ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77019-5318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-638-1427
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 101525
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------