Provider Demographics
| NPI: | 1457720120 |
|---|---|
| Name: | NORTH TEXAS BEHAVIORAL HEALTH AUTHORITY |
| Entity Type: | Organization |
| Organization Name: | NORTH TEXAS BEHAVIORAL HEALTH AUTHORITY |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
| Authorized Official - Prefix: | MS |
| Authorized Official - First Name: | CAROL |
| Authorized Official - Middle Name: | E |
| Authorized Official - Last Name: | LUCKY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 214-299-9373 |
| Mailing Address - Street 1: | 8111 LYNDON B JOHNSON FWY STE 900 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | DALLAS |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 75251-1322 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 214-366-9407 |
| Mailing Address - Fax: | 214-366-9417 |
| Practice Address - Street 1: | 8111 LYNDON B JOHNSON FWY STE 900 |
| Practice Address - Street 2: | |
| Practice Address - City: | DALLAS |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 75251-1322 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 214-366-9407 |
| Practice Address - Fax: | 214-366-9417 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2015-09-23 |
| Last Update Date: | 2024-01-03 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
| No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
| No | 172V00000X | Other Service Providers | Community Health Worker | Group - Multi-Specialty | |
| No | 175T00000X | Other Service Providers | Peer Specialist | Group - Multi-Specialty | |
| No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
| No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
| No | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | Group - Multi-Specialty |
| No | 323P00000X | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | Group - Multi-Specialty | |
| No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
| No | 385H00000X | Respite Care Facility | Respite Care | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TX | 011556147 | Other | DUNS NUMBER |
| TX | 011556147 | Other | DUNS NUMBER |
