Provider Demographics
NPI:1023576055
Name:TEXAS ONLINE COUNSELING PLLC
Entity Type:Organization
Organization Name:TEXAS ONLINE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:INAUEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC AND LMFT
Authorized Official - Phone:888-317-7021
Mailing Address - Street 1:2023 W RANCH RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-5029
Mailing Address - Country:US
Mailing Address - Phone:888-317-7021
Mailing Address - Fax:888-317-7021
Practice Address - Street 1:926 WITHERBY LN
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4477
Practice Address - Country:US
Practice Address - Phone:888-317-7021
Practice Address - Fax:888-317-7021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14079397649Medicaid