Provider Demographics
NPI:1558024562
Name:OVERCOMERS COUNSELING & ASSOCIATES LLC
Entity Type:Organization
Organization Name:OVERCOMERS COUNSELING & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALTON
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:COOK
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC
Authorized Official - Phone:469-223-9660
Mailing Address - Street 1:8500 N STEMMONS FWY STE 3052
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-3969
Mailing Address - Country:US
Mailing Address - Phone:469-223-9660
Mailing Address - Fax:
Practice Address - Street 1:8500 N STEMMONS FWY STE 3052
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-3969
Practice Address - Country:US
Practice Address - Phone:469-223-9660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-17
Last Update Date:2021-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty