Provider Demographics
NPI:1033303375
Name:GLENDA FAULKNER COUNSELING, PLLC
Entity Type:Organization
Organization Name:GLENDA FAULKNER COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:FAULKNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:214-923-8712
Mailing Address - Street 1:1117 BEDFORD RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6694
Mailing Address - Country:US
Mailing Address - Phone:972-318-0256
Mailing Address - Fax:817-285-1717
Practice Address - Street 1:1117 BEDFORD RD
Practice Address - Street 2:SUITE C
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6694
Practice Address - Country:US
Practice Address - Phone:972-318-0256
Practice Address - Fax:817-285-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15239251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health