MEDICARE: UNTYING KNOTS COUNSELING, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	104100000X	Social Worker
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor
4	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1851121032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNTYING KNOTS COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	3001 BLACK HILLS BLVD
Second Line	:
City	:	HEATH
State	:	TX
Zip	:	75126-0615
Country	:	US
Telephone Number	:	214-425-6316
Fax Number	:	945-468-7343

Provider Business Practice Location Address
First Line	:	205 E US HIGHWAY 80 STE 125
Second Line	:
City	:	FORNEY
State	:	TX
Zip	:	75126-8608
Country	:	US
Telephone Number	:	469-730-6650
Fax Number	:	945-468-7343

Authorized Official
Title or Position	:	CLINICAL THERAPIST
Name	:	MEGAN YOUNG
Credential	:	LCSW-S
Telephone Number	:	469-730-6650

Provider Enumeration Date	:	08/03/2024
Last Update Date	:	05/18/2026

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