Provider Demographics
NPI:1801279187
Name:PREMIER BEHAVIORAL HEALTH, PLLC
Entity type:Organization
Organization Name:PREMIER BEHAVIORAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARABURDA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:972-836-8051
Mailing Address - Street 1:1428 W HEBRON PKWY
Mailing Address - Street 2:SUITE 135
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-6345
Mailing Address - Country:US
Mailing Address - Phone:972-836-8051
Mailing Address - Fax:972-695-4005
Practice Address - Street 1:1428 W HEBRON PKWY
Practice Address - Street 2:SUITE 135
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-6345
Practice Address - Country:US
Practice Address - Phone:972-836-8051
Practice Address - Fax:972-695-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-03
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty