Provider Demographics
NPI:1659961852
Name:NOC CLINICAL COUNSELING AND CONSULTING PLLC
Entity Type:Organization
Organization Name:NOC CLINICAL COUNSELING AND CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC-S
Authorized Official - Phone:469-215-5713
Mailing Address - Street 1:1400 N COIT RD STE 506
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6657
Mailing Address - Country:US
Mailing Address - Phone:469-215-5713
Mailing Address - Fax:249-215-2523
Practice Address - Street 1:1400 N COIT RD STE 506
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-6657
Practice Address - Country:US
Practice Address - Phone:469-215-5713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX344318601Medicaid