Provider Demographics
NPI:1124253687
Name:PYLES, TRACI MECHELLE (LPC)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:MECHELLE
Last Name:PYLES
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 1:2016 JUSTIN RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7180
Mailing Address - Country:US
Mailing Address - Phone:972-317-4673
Mailing Address - Fax:972-317-1106
Practice Address - Street 1:2016 JUSTIN RD
Practice Address - Street 2:SUITE 350
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-7180
Practice Address - Country:US
Practice Address - Phone:972-317-4673
Practice Address - Fax:972-317-1106
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62464101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health