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General NPI Number Information
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NPI Number | 1942612726
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Entity Type | Organization
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Legal Business Name | FLOURISH COUNSELING AND CONSULTATION, PLLC
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 533 W 12TH ST
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City | DALLAS
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State | TX
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Zip | 75208-6319
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Country | US
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Telephone | 972-755-9120
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Fax |
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Provider Business Mailing Address
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Address Line | 533 W 12TH ST
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City | DALLAS
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State | TX
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Zip | 75208-6319
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Country | US
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Telephone | 972-755-9120
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Fax |
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Authorized Official
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Title or Position | THERAPIST AND OWNER
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Name | KAMBRIA KENNEDY-DOMINGUEZ
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Credential | MS, LPC, LCDC
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Telephone | 214-770-5335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 69806
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License Number State | TX
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