Provider Demographics
NPI:1750824991
Name:MOBILE COUNSELING, PLLC
Entity Type:Organization
Organization Name:MOBILE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:STUBBLEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC-S
Authorized Official - Phone:214-542-5642
Mailing Address - Street 1:1412 MAIN ST
Mailing Address - Street 2:SUITE 613
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202-4014
Mailing Address - Country:US
Mailing Address - Phone:214-542-5642
Mailing Address - Fax:
Practice Address - Street 1:1412 MAIN ST
Practice Address - Street 2:SUITE 613
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75202-4014
Practice Address - Country:US
Practice Address - Phone:214-542-5642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62980101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty