Provider Demographics
NPI:1467914366
Name:RARE BIRD COUNSELING
Entity Type:Organization
Organization Name:RARE BIRD COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:817-653-3663
Mailing Address - Street 1:200 N KIMBALL AVE STE 221
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6660
Mailing Address - Country:US
Mailing Address - Phone:817-653-3663
Mailing Address - Fax:
Practice Address - Street 1:230 N PARK BLVD STE 103
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-6981
Practice Address - Country:US
Practice Address - Phone:817-653-3663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)