Provider Demographics
NPI:1578814463
Name:GRAMMER, WILLIAM ARCHIE (LPC/LMFT/CST)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ARCHIE
Last Name:GRAMMER
Suffix:
Gender:M
Credentials:LPC/LMFT/CST
Other - Prefix:MR
Other - First Name:BILLY
Other - Middle Name:
Other - Last Name:GRAMMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC/LMFT/CST
Mailing Address - Street 1:12820 HILLCREST RD
Mailing Address - Street 2:SUITE C-203
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1526
Mailing Address - Country:US
Mailing Address - Phone:214-766-8886
Mailing Address - Fax:
Practice Address - Street 1:12820 HILLCREST RD
Practice Address - Street 2:SUITE C-203
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1526
Practice Address - Country:US
Practice Address - Phone:214-766-8886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9136101YP2500X
TX2542106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist