=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538429311
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LUMAR COUNSELING & FAMILY SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/25/2012
-----------------------------------------------------
Last Update Date | 07/22/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 346 OAKS TRL STE 215
-----------------------------------------------------
City | GARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75043-4094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-408-9660
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5100 ELDORADO PKWY STE 102 #528
-----------------------------------------------------
City | MCKINNEY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75070-6510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-369-6959
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | THERAPIST
-----------------------------------------------------
Name | DR. SHELIA ELAINE LUMAR
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 972-369-6959
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 65876
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------