Provider Demographics
NPI:1477191146
Name:CARROLLTON COUNSELING AND WELLNESS, PLLC
Entity Type:Organization
Organization Name:CARROLLTON COUNSELING AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GLOYNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-564-8358
Mailing Address - Street 1:2340 E TRINITY MILLS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-1947
Mailing Address - Country:US
Mailing Address - Phone:972-564-8358
Mailing Address - Fax:
Practice Address - Street 1:2340 E TRINITY MILLS RD STE 300
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1947
Practice Address - Country:US
Practice Address - Phone:972-564-8358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty