Provider Demographics
NPI:1841568508
Name:CENTER FOR MARRIAGE AND FAMILY COUNSELING
Entity Type:Organization
Organization Name:CENTER FOR MARRIAGE AND FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:D
Authorized Official - Last Name:ADAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:214-250-7808
Authorized Official - Phone:214-250-7808
Mailing Address - Street 1:860 HEBRON PKWY
Mailing Address - Street 2:#1102
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-5151
Mailing Address - Country:US
Mailing Address - Phone:214-250-7808
Mailing Address - Fax:972-315-6161
Practice Address - Street 1:3203 OVERHILL DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1158
Practice Address - Country:US
Practice Address - Phone:214-250-7808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53600251S00000X
UT296205-3501251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health