Provider Demographics
NPI:1932426707
Name:BERENT, TANYA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:
Last Name:BERENT
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 1:9323 DOVE MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6326
Mailing Address - Country:US
Mailing Address - Phone:214-349-8778
Mailing Address - Fax:
Practice Address - Street 1:9323 DOVE MEADOW DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6326
Practice Address - Country:US
Practice Address - Phone:214-349-8778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17709101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health