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General NPI Number Information
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NPI Number | 1790276285
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Entity Type | Organization
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Legal Business Name | HIGHLAND VILLAGE COUNSELING
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 2570 JUSTIN RD STE 202
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-3096
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Country | US
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Telephone | 214-546-9597
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 LONGHORN DR
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City | AUBREY
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State | TX
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Zip | 76227-2372
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Country | US
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Telephone | 214-546-9597
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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 | CAROL LYNN WOODARD
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Credential | LPC
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Telephone | 214-546-9597
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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 | 74943
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License Number State | TX
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