Provider Demographics
NPI:1659084796
Name:RESPIRE CREATIVE COUNSELING PLLC
Entity Type:Organization
Organization Name:RESPIRE CREATIVE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-ASSOCIATE
Authorized Official - Phone:214-717-9501
Mailing Address - Street 1:1112 MOURNING DOVE DR
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-0301
Mailing Address - Country:US
Mailing Address - Phone:214-717-9501
Mailing Address - Fax:
Practice Address - Street 1:1112 MOURNING DOVE DR
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-0301
Practice Address - Country:US
Practice Address - Phone:214-717-9501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty