Provider Demographics
NPI:1326502741
Name:SELF AND OTHER COUNSELING, PLLC
Entity Type:Organization
Organization Name:SELF AND OTHER COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:DAGMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SVETCOV
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LSOTP, CST
Authorized Official - Phone:925-998-0465
Mailing Address - Street 1:6604 ERIN LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:TX
Mailing Address - Zip Code:75002-5438
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 S WATTERS RD STE 263
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5231
Practice Address - Country:US
Practice Address - Phone:972-793-8488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty