MEDICARE: DRENNAN AND ASSOCIATES CHRISTIAN COUNSELING

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	101YP1600X	Pastoral Counselor
2	101YP2500X	Professional Counselor	64436	TX
3	101YP2500X	Professional Counselor	11660	TX

General Provider Information

NPI Number	:	1942630546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRENNAN AND ASSOCIATES CHRISTIAN COUNSELING

Provider Business Mailing Address
First Line	:	6060 N CENTRAL EXPY STE 308
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-5204
Country	:	US
Telephone Number	:	214-368-7373
Fax Number	:

Provider Business Practice Location Address
First Line	:	6060 N CENTRAL EXPY STE 308
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-5204
Country	:	US
Telephone Number	:	214-368-7373
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MELISSA CLARK
Credential	:	MA, LPC
Telephone Number	:	214-368-7373

Provider Enumeration Date	:	11/18/2013
Last Update Date	:	11/18/2013

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