MEDICARE: THE SOURCE COUNSELING, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1578285441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE SOURCE COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	6060 N CENTRAL EXPY STE 320
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-5204
Country	:	US
Telephone Number	:	214-810-0872
Fax Number	:

Provider Business Practice Location Address
First Line	:	6060 N CENTRAL EXPY STE 320
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-5204
Country	:	US
Telephone Number	:	214-810-0872
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMERA SERGIE
Credential	:	LPC-S
Telephone Number	:	214-810-0872

Provider Enumeration Date	:	09/16/2022
Last Update Date	:	06/18/2026

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Directions to “THE SOURCE COUNSELING, PLLC ” Practice Location

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