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General NPI Number Information
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NPI Number | 1780068262
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Entity Type | Organization
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Legal Business Name | MYPATHCOUNSELING, PLLC
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 5924 ROYAL LN SUITE 265
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City | DALLAS
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State | TX
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Zip | 75230-3863
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Country | US
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Telephone | 214-945-2599
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Fax |
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Provider Business Mailing Address
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Address Line | 5924 ROYAL LN SUITE 265
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City | DALLAS
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State | TX
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Zip | 75230-3863
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Country | US
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Telephone | 214-945-2599
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MRS. CHRISTIANE ROEHRBORN
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Credential | SLP, LCDC, LPC, LMFT
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Telephone | 214-945-2599
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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 | 11829
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 201916
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License Number State | TX
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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 | 69479
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License Number State | TX
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