MEDICARE: FOCUS BEACH COUNSELING, PLLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1982361762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOCUS BEACH COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	6610 HILLTOP TRL
Second Line	:
City	:	SACHSE
State	:	TX
Zip	:	75048-2846
Country	:	US
Telephone Number	:	214-646-5778
Fax Number	:

Provider Business Practice Location Address
First Line	:	8105 RASOR BLVD STE 238
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-0154
Country	:	US
Telephone Number	:	214-646-5778
Fax Number	:

Authorized Official
Title or Position	:	GOVERNING PERSON
Name	:	REBEKAH JOHNSON
Credential	:	LPC
Telephone Number	:	214-646-5778

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	11/29/2021

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