Provider Demographics
NPI:1518551456
Name:REWRITE YOUR STORY COUNSELING AND CONSULTING, PLLC
Entity Type:Organization
Organization Name:REWRITE YOUR STORY COUNSELING AND CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BURLESON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,LCDC,MAC
Authorized Official - Phone:830-357-8933
Mailing Address - Street 1:12235 RED HAWK DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-1606
Mailing Address - Country:US
Mailing Address - Phone:830-357-8933
Mailing Address - Fax:
Practice Address - Street 1:2591 DALLAS PKWY STE 300
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-8563
Practice Address - Country:US
Practice Address - Phone:830-357-8933
Practice Address - Fax:830-240-8096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty