Provider Demographics
NPI:1437532744
Name:THERAPRIDE, PLLC
Entity Type:Organization
Organization Name:THERAPRIDE, PLLC
Other - Org Name:BROYLES COUNSELING, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BROYLES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCPC, LPC-S
Authorized Official - Phone:940-334-0812
Mailing Address - Street 1:7204 RED CEDAR CT
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-7601
Mailing Address - Country:US
Mailing Address - Phone:214-326-0737
Mailing Address - Fax:214-326-0737
Practice Address - Street 1:7204 RED CEDAR CT
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208-7601
Practice Address - Country:US
Practice Address - Phone:214-326-0737
Practice Address - Fax:833-222-3602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-06
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71875101YP2500X
101YP2500X, 1041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty