Provider Demographics
NPI:1487210191
Name:DALLAS COGNITIVE WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:DALLAS COGNITIVE WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-732-9300
Mailing Address - Street 1:10724 SAINT LAZARE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-5346
Mailing Address - Country:US
Mailing Address - Phone:214-732-9300
Mailing Address - Fax:
Practice Address - Street 1:7859 WALNUT HILL LN STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-5637
Practice Address - Country:US
Practice Address - Phone:469-405-0877
Practice Address - Fax:469-405-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-17
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty