Provider Demographics
NPI:1417340753
Name:MOBILE COUNSELING, PLLC
Entity Type:Organization
Organization Name:MOBILE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:(JANIE)
Authorized Official - Last Name:STUBBLEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC-S
Authorized Official - Phone:214-542-5642
Mailing Address - Street 1:1910 PACIFIC AVE
Mailing Address - Street 2:SUITE 8014
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-4529
Mailing Address - Country:US
Mailing Address - Phone:214-542-5642
Mailing Address - Fax:888-972-6925
Practice Address - Street 1:1910 PACIFIC AVE
Practice Address - Street 2:SUITE 8014
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-4529
Practice Address - Country:US
Practice Address - Phone:214-542-5642
Practice Address - Fax:888-972-6925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62980101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty