Provider Demographics
NPI:1457854895
Name:UNIVERSAL COUCH COUNSELING SERVICES
Entity Type:Organization
Organization Name:UNIVERSAL COUCH COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHIS-THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:214-356-0990
Mailing Address - Street 1:533 FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-2321
Mailing Address - Country:US
Mailing Address - Phone:214-356-0990
Mailing Address - Fax:972-218-8076
Practice Address - Street 1:533 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-2321
Practice Address - Country:US
Practice Address - Phone:214-356-0990
Practice Address - Fax:972-218-8076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75644101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty