Provider Demographics
NPI:1225464365
Name:WYSONG-WAREN, ERIN L (LPC-S)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:L
Last Name:WYSONG-WAREN
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:L
Other - Last Name:WYSONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4144 N CENTRAL EXPY STE 380
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-3218
Mailing Address - Country:US
Mailing Address - Phone:214-906-5138
Mailing Address - Fax:214-366-3323
Practice Address - Street 1:4144 N CENTRAL EXPY STE 380
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-3218
Practice Address - Country:US
Practice Address - Phone:214-906-5138
Practice Address - Fax:214-366-3323
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70992101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional