MEDICARE: KANDER COUNSELING AND CONSULTING

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1265383939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KANDER COUNSELING AND CONSULTING

Provider Business Mailing Address
First Line	:	5473 BLAIR RD STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4227
Country	:	US
Telephone Number	:	972-779-5486
Fax Number	:

Provider Business Practice Location Address
First Line	:	3412 SLOANE ST APT 311
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-2353
Country	:	US
Telephone Number	:	972-779-5486
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	AUTUMN MAXWELL
Credential	:	LPC-A
Telephone Number	:	614-512-2650

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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Directions to “KANDER COUNSELING AND CONSULTING ” Practice Location

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