Provider Demographics
NPI:1932480373
Name:TRANSITIONS COUNSELING SERVICE
Entity Type:Organization
Organization Name:TRANSITIONS COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFSKILL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:817-680-9218
Mailing Address - Street 1:4214 SCOTLAND DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-4236
Mailing Address - Country:US
Mailing Address - Phone:817-680-9218
Mailing Address - Fax:469-212-9615
Practice Address - Street 1:1101 N LITTLE SCHOOL RD
Practice Address - Street 2:SUITE B
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1900
Practice Address - Country:US
Practice Address - Phone:817-680-9218
Practice Address - Fax:469-212-9615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8187101YA0400X
TX18736101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1645723-01Medicaid