MEDICARE: MR. STUART WALTON COUCH MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	7553	TX
2	101YM0800X	Mental Health Counselor	9451	TX
3	106H00000X	Marriage & Family Therapist	035207	TX

General Provider Information

NPI Number	:	1083637938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STUART WALTON COUCH MA

Provider Business Mailing Address
First Line	:	6440 N CENTRAL EXPY STE 314
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-4132
Country	:	US
Telephone Number	:	214-365-0777
Fax Number	:	214-365-0778

Provider Business Practice Location Address
First Line	:	6440 N CENTRAL EXPY STE 314
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-4132
Country	:	US
Telephone Number	:	214-365-0777
Fax Number	:	214-365-0778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	01/22/2026

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