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General NPI Number Information
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NPI Number | 1669197612
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Entity Type | Organization
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Legal Business Name | M.B.S WHOLE HEALTH
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 2451 W GRAPEVINE MILLS CIR # 1053
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City | GRAPEVINE
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State | TX
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Zip | 76051-2096
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Country | US
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Telephone | 682-292-8306
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Fax |
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Provider Business Mailing Address
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Address Line | 2451 W GRAPEVINE MILLS CIR # 1053
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City | GRAPEVINE
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State | TX
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Zip | 76051-2096
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Country | US
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Telephone | 682-292-8306
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NATASHA L MONTGOMERY
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Credential | LPC, LCDC
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Telephone | 682-292-8306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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