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General NPI Number Information
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NPI Number | 1528338340
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Entity Type | Organization
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Legal Business Name | THE NEUROPSYCHOLOGY & COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 4101 MCEWEN RD STE 318
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City | DALLAS
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State | TX
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Zip | 75244-5257
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Country | US
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Telephone | 469-975-2411
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 MCEWEN RD STE 318
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City | DALLAS
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State | TX
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Zip | 75244-5257
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Country | US
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Telephone | 469-975-2411
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. CARLOS DANIEL MARQUEZ DE LA PLATA
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Credential | PHD
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Telephone | 469-975-2411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 33990
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 33990
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 33990
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License Number State | TX
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