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General NPI Number Information
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NPI Number | 1801279187
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Entity Type | Organization
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Legal Business Name | PREMIER BEHAVIORAL HEALTH, PLLC
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Dates
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Enumeration Date | 07/03/2015
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 1428 W HEBRON PKWY SUITE 135
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City | CARROLLTON
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State | TX
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Zip | 75010-6345
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Country | US
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Telephone | 972-836-8051
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Fax | 972-695-4005
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Provider Business Mailing Address
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Address Line | 1428 W HEBRON PKWY SUITE 135
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City | CARROLLTON
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State | TX
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Zip | 75010-6345
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Country | US
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Telephone | 972-836-8051
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Fax | 972-695-4005
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Authorized Official
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Title or Position | OWNER/PRACTICE MANAGER
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Name | STEPHANIE HARABURDA
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Credential | LPC
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Telephone | 972-836-8051
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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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