Provider Demographics
NPI:1104942861
Name:COLCLASURE, JAMES L (LPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:COLCLASURE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3823 RIDGEOAK WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5432
Mailing Address - Country:US
Mailing Address - Phone:972-407-6805
Mailing Address - Fax:972-387-3987
Practice Address - Street 1:4099 MCEWEN RD
Practice Address - Street 2:SUITE 600
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5030
Practice Address - Country:US
Practice Address - Phone:972-387-3898
Practice Address - Fax:972-387-3987
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX12949101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional