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General NPI Number Information
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NPI Number | 1639447113
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Entity Type | Organization
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Legal Business Name | DAVIDSON COUNSELING GROUP PC
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Dates
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Enumeration Date | 12/12/2011
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Last Update Date | 12/12/2011
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Provider Practice Location Address
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Address Line | 7800 PRESTON RD STE 145
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City | PLANO
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State | TX
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Zip | 75024-3239
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Country | US
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Telephone | 972-251-9615
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Fax | 877-581-3908
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Provider Business Mailing Address
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Address Line | 3500 WILSHIRE DR
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City | PLANO
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State | TX
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Zip | 75023-6017
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Country | US
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Telephone | 972-251-9615
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Fax | 877-581-3908
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Authorized Official
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Title or Position | CEO
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Name | JAMES DAVIDSON
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Credential | PH.D.
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Telephone | 972-251-9615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 36019
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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 | 36018
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License Number State | TX
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