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General NPI Number Information
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NPI Number | 1851795801
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Entity Type | Organization
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Legal Business Name | PEACEFUL RAIN COUNSELING CENTER
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Dates
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Enumeration Date | 10/20/2014
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Last Update Date | 10/20/2014
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Provider Practice Location Address
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Address Line | 602 STRADA CIR SUITE 118
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City | MANSFIELD
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State | TX
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Zip | 76063-3201
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Country | US
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Telephone | 214-476-0996
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Fax |
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Provider Business Mailing Address
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Address Line | 6955 CLAY ACADEMY BLVD
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City | DALLAS
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State | TX
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Zip | 75236-3025
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Country | US
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Telephone | 214-476-0996
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Fax |
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Authorized Official
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Title or Position | OWNER / COUNSELOR
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Name | STEPHANIE MARQUES
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Credential |
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Telephone | 214-476-0996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 69472
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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 | 69472
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 69472
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License Number State | TX
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