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NPI Code Detail

MEDICARE: LDS FAMILY SERVICES

MEDICARE: LDS FAMILY SERVICES
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
1101YM0800XMental Health Counselor12587TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10003NF - 84007LOTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1659432847
Entity Type Code : Organization
Provider Name (Legal Business Name) : LDS FAMILY SERVICES
Provider Business Mailing Address
First Line : 1100 W JACKSON RD
Second Line :
City : CARROLLTON
State : TX
Zip : 75006-1316
Country : US
Telephone Number : 972-242-2182
Fax Number : 972-242-9232
Provider Business Practice Location Address
First Line : 1100 W JACKSON RD
Second Line :
City : CARROLLTON
State : TX
Zip : 75006-1316
Country : US
Telephone Number : 972-242-2182
Fax Number : 972-242-9232
Authorized Official
Title or Position : COUNSELING MANAGER
Name : ERIC OAKES LARSON
Credential : LCSW
Telephone Number : 214-538-7847
Provider Enumeration Date : 12/12/2006
Last Update Date : 05/08/2012

Similar Medicare Providers

1265583967 — JANE ANN WILLIAMS MS
Practice Location Address:
1100 W JACKSON RD
CARROLLTON, TX
75006-1316
Practice Phone: 972-242-2182
Practice Fax:
1689728255 — MS. JODY LEE EBERT MS LPC
Practice Location Address:
1100 W JACKSON RD
CARROLLTON, TX
75006-1316
Practice Phone: 972-242-2182
Practice Fax:
1780711309 — LDS FAMILY SERVICES
Practice Location Address:
1100 W JACKSON RD
CARROLLTON, TX
75006-1316
Practice Phone: 972-242-2182
Practice Fax: 972-242-2932
1861616724 — ERIC OAKES LARSON LCSW
Practice Location Address:
1100 W JACKSON RD
CARROLLTON, TX
75006-1316
Practice Phone: 972-242-2182
Practice Fax: 972-242-2932
1184848608 — ROBBIN TODD HOLLEY LPC
Practice Location Address:
1100 W JACKSON RD
CARROLLTON, TX
75006-1316
Practice Phone: 972-242-2182
Practice Fax: 972-242-2932
1437444502 — MRS. MICHELLE PARKIN HEPWORTH MAC, LMFTA
Practice Location Address:
1100 W JACKSON RD
CARROLLTON, TX
75006-1316
Practice Phone: 817-876-9824
Practice Fax: 972-242-2932

Directions to “LDS FAMILY SERVICES ” Practice Location

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