Provider Demographics
NPI:1184396475
Name:PRINCIPAL COUNSELING, LLC
Entity type:Organization
Organization Name:PRINCIPAL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRIMARY CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:MICHELENE
Authorized Official - Last Name:FRASER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:817-983-4141
Mailing Address - Street 1:4329 SILVERWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-4961
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9153 BELSHIRE DR STE 140
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-7691
Practice Address - Country:US
Practice Address - Phone:817-983-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty