Provider Demographics
NPI:1881008126
Name:MARY DAINTY, M.A., LPC-S
Entity Type:Organization
Organization Name:MARY DAINTY, M.A., LPC-S
Other - Org Name:TEXAS LPC SUPERVISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNSELOR SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAINTY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:682-235-3401
Mailing Address - Street 1:1810 8TH AVE
Mailing Address - Street 2:SUITE B204, 2ND FLOOR
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110-1352
Mailing Address - Country:US
Mailing Address - Phone:682-235-3401
Mailing Address - Fax:413-208-3830
Practice Address - Street 1:1810 8TH AVE
Practice Address - Street 2:SUITE B204, 2ND FLOOR
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-1352
Practice Address - Country:US
Practice Address - Phone:682-235-3401
Practice Address - Fax:413-208-3830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-14
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18640101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty