Provider Demographics
NPI:1518108414
Name:COACH ABBY, INC. COUNSELING SERVICES
Entity Type:Organization
Organization Name:COACH ABBY, INC. COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED COUNSELOR/ PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBBIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:REDMON
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:469-916-4200
Mailing Address - Street 1:10300 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 293
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-8600
Mailing Address - Country:US
Mailing Address - Phone:469-916-4200
Mailing Address - Fax:214-943-2429
Practice Address - Street 1:10300 N CENTRAL EXPY
Practice Address - Street 2:SUITE 293
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-8600
Practice Address - Country:US
Practice Address - Phone:469-916-4200
Practice Address - Fax:214-943-2429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62134261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)