Provider Demographics
NPI:1831503457
Name:THERAPY & BEYOND OF NORTH TEXAS
Entity type:Organization
Organization Name:THERAPY & BEYOND OF NORTH TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREATMENT DEVELOPMENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TASHENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLMORE
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:469-892-7500
Mailing Address - Street 1:3620 N JOSEY LN
Mailing Address - Street 2:STE 210
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-3157
Mailing Address - Country:US
Mailing Address - Phone:469-892-7500
Mailing Address - Fax:888-237-2214
Practice Address - Street 1:3630 N JOSEY LN
Practice Address - Street 2:STE 100
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-3159
Practice Address - Country:US
Practice Address - Phone:469-892-7500
Practice Address - Fax:888-237-2214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health