Provider Demographics
NPI:1144573239
Name:PRESTIGE EVALUATION AND CONSULTING SERVICES, LLC
Entity Type:Organization
Organization Name:PRESTIGE EVALUATION AND CONSULTING SERVICES, LLC
Other - Org Name:PRESTIGE ECS
Other - Org Type:Other Name
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DARALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PLAINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-563-7353
Mailing Address - Street 1:828 BESSEMER DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-6985
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:828 BESSEMER DR
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-6985
Practice Address - Country:US
Practice Address - Phone:214-563-7353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36130103TB0200X, 103TC2200X
TX33707103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty