Provider Demographics
NPI:1528338340
Name:THE NEUROPSYCHOLOGY & COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:THE NEUROPSYCHOLOGY & COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MARQUEZ DE LA PLATA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:469-975-2411
Mailing Address - Street 1:4101 MCEWEN RD STE 318
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5257
Mailing Address - Country:US
Mailing Address - Phone:469-975-2411
Mailing Address - Fax:
Practice Address - Street 1:4101 MCEWEN RD STE 318
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5257
Practice Address - Country:US
Practice Address - Phone:469-975-2411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33990101Y00000X, 103TC0700X, 103G00000X
261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty