MEDICARE: AMERIPSYCH MENTAL HEALTH & HOLISTIC CLINIC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1548127434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERIPSYCH MENTAL HEALTH & HOLISTIC CLINIC

Provider Business Mailing Address
First Line	:	4040 N CENTRAL EXPY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-3158
Country	:	US
Telephone Number	:	214-463-0214
Fax Number	:	214-463-0214

Provider Business Practice Location Address
First Line	:	4040 N CENTRAL EXPY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-3158
Country	:	US
Telephone Number	:	214-463-0214
Fax Number	:	214-463-0214

Authorized Official
Title or Position	:	OWNER
Name	:	BLESSING DAN-DUKOR
Credential	:
Telephone Number	:	214-463-0214

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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