Provider Demographics
NPI:1356635445
Name:EXCEEDEA LLC
Entity Type:Organization
Organization Name:EXCEEDEA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAYAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PUNATAR
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:972-836-8387
Mailing Address - Street 1:2037 CAMELOT DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3017
Mailing Address - Country:US
Mailing Address - Phone:972-836-8387
Mailing Address - Fax:
Practice Address - Street 1:2419 COIT RD
Practice Address - Street 2:SUITE C
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3731
Practice Address - Country:US
Practice Address - Phone:972-836-8387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62585101Y00000X, 101YM0800X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty