Provider Demographics
NPI:1679116909
Name:ORIGINS COUNSELING LLC
Entity Type:Organization
Organization Name:ORIGINS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:DE LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-201-8209
Mailing Address - Street 1:4001 MAPLE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3241
Mailing Address - Country:US
Mailing Address - Phone:214-817-4964
Mailing Address - Fax:210-634-3961
Practice Address - Street 1:12870 HILLCREST RD STE H226
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1531
Practice Address - Country:US
Practice Address - Phone:214-817-4964
Practice Address - Fax:210-634-3961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty