Provider Demographics
NPI:1407295157
Name:REDBUD COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:REDBUD COUNSELING SERVICES, PLLC
Other - Org Name:MARK COLLINS, LCSW
Other - Org Type:Other Name
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-687-8365
Mailing Address - Street 1:2233 BISCAYNE DR W
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060-7216
Mailing Address - Country:US
Mailing Address - Phone:214-687-8365
Mailing Address - Fax:
Practice Address - Street 1:8204 ELMBROOK DR
Practice Address - Street 2:SUITE 305-B
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4067
Practice Address - Country:US
Practice Address - Phone:214-687-8365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36594251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health