Provider Demographics
NPI:1154809275
Name:TEXAS BEHAVIORAL COUNSELING
Entity type:Organization
Organization Name:TEXAS BEHAVIORAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, NCC
Authorized Official - Phone:817-988-9635
Mailing Address - Street 1:7100 S COOPER ST STE 9
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-6718
Mailing Address - Country:US
Mailing Address - Phone:817-988-9635
Mailing Address - Fax:817-549-9993
Practice Address - Street 1:7100 S COOPER ST STE 9
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-6718
Practice Address - Country:US
Practice Address - Phone:817-988-9635
Practice Address - Fax:817-549-9993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3212011-01Medicaid