Provider Demographics
NPI:1093190811
Name:REVISION COUNSELING SERVICES PLLC
Entity Type:Organization
Organization Name:REVISION COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SATZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:972-897-0957
Mailing Address - Street 1:15150 PRESTON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4871
Mailing Address - Country:US
Mailing Address - Phone:972-897-0957
Mailing Address - Fax:
Practice Address - Street 1:513 COPPER RIDGE DR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2309
Practice Address - Country:US
Practice Address - Phone:972-897-1070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68452251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management