Provider Demographics
NPI:1700583390
Name:GUMMELT, TENLEY (LPC)
Entity Type:Individual
Prefix:
First Name:TENLEY
Middle Name:
Last Name:GUMMELT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 W PLANO PKWY STE 1400
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-8607
Mailing Address - Country:US
Mailing Address - Phone:972-212-9175
Mailing Address - Fax:
Practice Address - Street 1:2001 W PLANO PKWY STE 1400
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-8607
Practice Address - Country:US
Practice Address - Phone:972-212-9175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78430101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional