Provider Demographics
NPI:1629631569
Name:INTENSIONAL COUNSELING LPC PC
Entity Type:Organization
Organization Name:INTENSIONAL COUNSELING LPC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:972-345-6788
Mailing Address - Street 1:10810 COPPERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-3969
Mailing Address - Country:US
Mailing Address - Phone:972-345-6788
Mailing Address - Fax:
Practice Address - Street 1:5850 TOWN AND COUNTRY BLVD STE 301
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6945
Practice Address - Country:US
Practice Address - Phone:817-205-1692
Practice Address - Fax:469-213-6473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty