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General NPI Number Information
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NPI Number | 1861292542
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Entity Type | Organization
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Legal Business Name | QUATTLEBAUM COUNSELING, PLLC
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 5005 COLLEYVILLE BLVD
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City | COLLEYVILLE
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State | TX
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Zip | 76034-5866
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Country | US
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Telephone | 214-564-9581
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 NORTHRIDGE DR
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City | HURST
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State | TX
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Zip | 76054-3724
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Country | US
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Telephone | 214-564-9581
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARY ELIZABETH QUATTLEBAUM
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Credential | LPC
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Telephone | 817-228-4301
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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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