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General NPI Number Information
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NPI Number | 1710594718
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Entity Type | Organization
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Legal Business Name | CLUTCH COUNSELING
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Dates
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Enumeration Date | 09/24/2020
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Last Update Date | 09/24/2020
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Provider Practice Location Address
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Address Line | 2001 E SPRING CREEK PKWY APT 9101
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City | PLANO
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State | TX
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Zip | 75074-3240
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Country | US
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Telephone | 214-924-1855
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 E SPRING CREEK PKWY APT 9101
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City | PLANO
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State | TX
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Zip | 75074-3240
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Country | US
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Telephone | 214-924-1855
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | COSALYN YOUNG
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Credential |
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Telephone | 214-924-1855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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