Provider Demographics
NPI:1447618020
Name:YOUNITY WELLNESS CENTER
Entity Type:Organization
Organization Name:YOUNITY WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:CHENEY
Authorized Official - Last Name:BONE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CRC
Authorized Official - Phone:254-744-9139
Mailing Address - Street 1:9603 WHITE ROCK TRL STE 109
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-5051
Mailing Address - Country:US
Mailing Address - Phone:254-744-9139
Mailing Address - Fax:
Practice Address - Street 1:9603 WHITE ROCK TRL STE 109
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-5051
Practice Address - Country:US
Practice Address - Phone:254-744-9139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69079251S00000X
TX90718251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health