Provider Demographics
NPI:1245705938
Name:KID TIME COUNSELING, PLLC
Entity type:Organization
Organization Name:KID TIME COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:MONTCALM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:940-268-3900
Mailing Address - Street 1:723 S I 35 E STE 111
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4102
Mailing Address - Country:US
Mailing Address - Phone:940-268-3900
Mailing Address - Fax:
Practice Address - Street 1:723 S I 35 E STE 111
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4102
Practice Address - Country:US
Practice Address - Phone:940-268-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX376325201Medicaid
TX376203Medicaid
TX376325202Medicaid
TX376325294Medicaid