Provider Demographics
NPI:1720229743
Name:LCDCCOUNSELING
Entity Type:Organization
Organization Name:LCDCCOUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR/SENIOR COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA;LCDC;ADS;LPC-I
Authorized Official - Phone:469-226-9982
Mailing Address - Street 1:1530 MONTREAL LN
Mailing Address - Street 2:
Mailing Address - City:GLENN HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:75154-8224
Mailing Address - Country:US
Mailing Address - Phone:469-226-9982
Mailing Address - Fax:
Practice Address - Street 1:1530 MONTREAL LN
Practice Address - Street 2:
Practice Address - City:GLENN HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:75154-8224
Practice Address - Country:US
Practice Address - Phone:469-226-9982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10826251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management