Provider Demographics
NPI:1275142739
Name:92 REASONS
Entity Type:Organization
Organization Name:92 REASONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTR OF CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:MCRC, CRC, LPC
Authorized Official - Phone:469-986-9629
Mailing Address - Street 1:1005 LAKE HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-8411
Mailing Address - Country:US
Mailing Address - Phone:469-986-9629
Mailing Address - Fax:469-453-3193
Practice Address - Street 1:1332 TEASLEY LN STE 103A
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-7946
Practice Address - Country:US
Practice Address - Phone:469-986-9629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SODA CANNON LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health