Provider Demographics
NPI:1821154246
Name:LUMLEY, MAUREEN JOAN (PHD, LM FT)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:JOAN
Last Name:LUMLEY
Suffix:
Gender:F
Credentials:PHD, LM FT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 SHADY BROOK CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-7212
Mailing Address - Country:US
Mailing Address - Phone:214-755-4107
Mailing Address - Fax:817-416-1047
Practice Address - Street 1:1207 S WHITE CHAPEL BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-9314
Practice Address - Country:US
Practice Address - Phone:214-755-4107
Practice Address - Fax:817-416-1047
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7638159OtherAETNA
TXLUML93216OtherAAMFT
TX9381325OtherPHCS
TX8152-4289OtherAPA
TX00213BMedicare UPIN