Provider Demographics
NPI:1619572336
Name:AWAKEN THERAPY
Entity Type:Organization
Organization Name:AWAKEN THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:NANNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:972-979-9100
Mailing Address - Street 1:6010 W SPRING CREEK PKWY # 246
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3569
Mailing Address - Country:US
Mailing Address - Phone:972-643-8243
Mailing Address - Fax:
Practice Address - Street 1:6010 W SPRING CREEK PKWY # 246
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3569
Practice Address - Country:US
Practice Address - Phone:972-643-8243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty