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General NPI Number Information
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NPI Number | 1801315866
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Entity Type | Organization
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Legal Business Name | TEXAS REHAB COUNSELING & ASSESSMENTS
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1332 TEASLEY LN # 103A
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City | DENTON
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State | TX
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Zip | 76205-7946
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Country | US
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Telephone | 469-986-9629
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Fax | 469-453-3193
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Provider Business Mailing Address
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Address Line | 1332 TEASLEY LN # 103A
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City | DENTON
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State | TX
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Zip | 76205-7946
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Country | US
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Telephone | 469-986-9629
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Fax | 469-453-3193
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | SOPHIA CANNON
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Credential |
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Telephone | 469-986-9629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 00230818
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License Number State | TX
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