Provider Demographics
NPI:1366082240
Name:CARBERY CENTER FOR CHILD DEVELOPMENT PLLC
Entity type:Organization
Organization Name:CARBERY CENTER FOR CHILD DEVELOPMENT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARBERY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:214-766-9197
Mailing Address - Street 1:3401 LEE PKWY APT 1904
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5228
Mailing Address - Country:US
Mailing Address - Phone:214-766-9197
Mailing Address - Fax:
Practice Address - Street 1:6060 N CENTRAL EXPY STE 222
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-5318
Practice Address - Country:US
Practice Address - Phone:214-766-9197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health