Provider Demographics
NPI:1356753362
Name:IRIS PSYCHOLOGICAL SERVICES, PLLC
Entity type:Organization
Organization Name:IRIS PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HENSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:817-962-0035
Mailing Address - Street 1:P.O. BOX 50564
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76006-6190
Mailing Address - Country:US
Mailing Address - Phone:817-962-0035
Mailing Address - Fax:
Practice Address - Street 1:1201 N WATSON RD
Practice Address - Street 2:SUITE 117
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-6190
Practice Address - Country:US
Practice Address - Phone:817-962-0035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-25
Last Update Date:2014-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36730103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty