Provider Demographics
NPI:1518665603
Name:WELCHMAN, JACQULINE RENAE (LPC-ASSOCIATE)
Entity Type:Individual
Prefix:MRS
First Name:JACQULINE
Middle Name:RENAE
Last Name:WELCHMAN
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 SUMMER LAKE TRL
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-6217
Mailing Address - Country:US
Mailing Address - Phone:214-923-6387
Mailing Address - Fax:
Practice Address - Street 1:6310 LYNDON B JOHNSON FWY STE 208
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6452
Practice Address - Country:US
Practice Address - Phone:214-923-6387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83839101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional