Provider Demographics
NPI:1245854199
Name:STRESS AND RELAXATION SERVICES OF AMERICA, PLLC
Entity type:Organization
Organization Name:STRESS AND RELAXATION SERVICES OF AMERICA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DI PAOLO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, NCC
Authorized Official - Phone:847-293-0544
Mailing Address - Street 1:4324 MAPLESHADE LN STE 240
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-0044
Mailing Address - Country:US
Mailing Address - Phone:847-293-0544
Mailing Address - Fax:
Practice Address - Street 1:4324 MAPLESHADE LN STE 240
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-0044
Practice Address - Country:US
Practice Address - Phone:847-293-0544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1871012252Medicaid