Provider Demographics
NPI:1124536842
Name:URBANIAK, MONICA (LMFTS)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:URBANIAK
Suffix:
Gender:F
Credentials:LMFTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 CORDOVA ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75223-1223
Mailing Address - Country:US
Mailing Address - Phone:214-952-5174
Mailing Address - Fax:
Practice Address - Street 1:6600 LYNDON B JOHNSON FWY STE 240
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6550
Practice Address - Country:US
Practice Address - Phone:214-347-9765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5120106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist