Provider Demographics
NPI:1023530649
Name:LYNDA CARMOUCHE PSYCHOTHERAPY & TRAINING, PLLC
Entity type:Organization
Organization Name:LYNDA CARMOUCHE PSYCHOTHERAPY & TRAINING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CARMOUCHE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:214-273-5045
Mailing Address - Street 1:PO BOX 613174
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75261-3174
Mailing Address - Country:US
Mailing Address - Phone:214-273-5045
Mailing Address - Fax:337-205-0814
Practice Address - Street 1:5601 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-2384
Practice Address - Country:US
Practice Address - Phone:214-273-5045
Practice Address - Fax:337-205-0814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)