Provider Demographics
NPI:1881366516
Name:COLEY, JAMES DANIEL JR (MS, LPC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DANIEL
Last Name:COLEY
Suffix:JR
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 WINDROW DR
Mailing Address - Street 2:
Mailing Address - City:JOSEPHINE
Mailing Address - State:TX
Mailing Address - Zip Code:75189-3844
Mailing Address - Country:US
Mailing Address - Phone:469-855-4834
Mailing Address - Fax:
Practice Address - Street 1:13500 MIDWAY RD STE 400
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-5155
Practice Address - Country:US
Practice Address - Phone:469-333-0153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85042101Y00000X, 101YP1600X, 101YM0800X
WI11046-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral