Provider Demographics
NPI:1164675500
Name:GARLAND'S CHRISTIAN COUNSELING CENTER
Entity Type:Organization
Organization Name:GARLAND'S CHRISTIAN COUNSELING CENTER
Other - Org Name:FELISHA HERNANDEZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELISHA
Authorized Official - Middle Name:LANETTE
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:972-897-4986
Mailing Address - Street 1:PO BOX 452244
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75045-2244
Mailing Address - Country:US
Mailing Address - Phone:972-897-4986
Mailing Address - Fax:214-703-9977
Practice Address - Street 1:3112 N JUPITER RD STE 203
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-6563
Practice Address - Country:US
Practice Address - Phone:972-897-4986
Practice Address - Fax:214-703-9977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58856101YP2500X
TX58190101YP2500X
TX282651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty