Provider Demographics
NPI:1134856958
Name:DOVE COUNSELING SERVICE PLLC
Entity type:Organization
Organization Name:DOVE COUNSELING SERVICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:D
Authorized Official - Last Name:DOVE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:817-688-7595
Mailing Address - Street 1:275 S DENTON TAP RD
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5051
Mailing Address - Country:US
Mailing Address - Phone:817-688-7595
Mailing Address - Fax:
Practice Address - Street 1:275 S DENTON TAP RD
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-5051
Practice Address - Country:US
Practice Address - Phone:817-688-7595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1629122635OtherNPI
TX16588OtherLPC LICENSE