Provider Demographics
NPI:1598237331
Name:TOTAL HEALING COUNSELING AND WELLNESS CENTER, PLLC
Entity Type:Organization
Organization Name:TOTAL HEALING COUNSELING AND WELLNESS CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TENAYA
Authorized Official - Middle Name:LACONDA
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:972-213-2549
Mailing Address - Street 1:1111 BELT LINE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-3201
Mailing Address - Country:US
Mailing Address - Phone:972-213-2549
Mailing Address - Fax:844-208-6008
Practice Address - Street 1:1111 BELT LINE RD STE 106
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-3201
Practice Address - Country:US
Practice Address - Phone:972-213-2549
Practice Address - Fax:844-208-6008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX76145OtherSTATE OF TEXAS LICENSE NUMBER- LPC