Provider Demographics
NPI:1215292081
Name:LOGOS SERVICES, LLC
Entity type:Organization
Organization Name:LOGOS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:J. TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC-S, NCC
Authorized Official - Phone:817-812-2880
Mailing Address - Street 1:5751 KROGER DR
Mailing Address - Street 2:SUITE 269
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5632
Mailing Address - Country:US
Mailing Address - Phone:817-812-2880
Mailing Address - Fax:
Practice Address - Street 1:5751 KROGER DR
Practice Address - Street 2:SUITE 269
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-5632
Practice Address - Country:US
Practice Address - Phone:817-812-2880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65472101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty