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General NPI Number Information
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NPI Number | 1538490354
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Entity Type | Organization
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Legal Business Name | SUCCESS ON PURPOSE
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Dates
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Enumeration Date | 01/18/2010
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Last Update Date | 01/18/2010
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Provider Practice Location Address
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Address Line | 402 W DANIELDALE RD
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City | DUNCANVILLE
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State | TX
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Zip | 75137-3928
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Country | US
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Telephone | 972-298-3614
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Fax | 972-709-8145
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Provider Business Mailing Address
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Address Line | PO BOX 380128
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City | DUNCANVILLE
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State | TX
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Zip | 75138-0128
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Country | US
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Telephone | 972-298-3614
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Fax | 972-709-8145
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Authorized Official
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Title or Position | PROVIDER
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Name | MS. LINDA JOHNSON
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Credential | M.ED, LPC
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Telephone | 972-298-3614
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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 | 7955
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License Number State | TX
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