Provider Demographics
NPI:1588084065
Name:CHERYL EDINBYRD COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:CHERYL EDINBYRD COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:EDINBYRD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCDC-I, PHD
Authorized Official - Phone:214-912-2614
Mailing Address - Street 1:1604 SHADOW CRK
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-3508
Mailing Address - Country:US
Mailing Address - Phone:214-912-2614
Mailing Address - Fax:
Practice Address - Street 1:8035 E RL THRTN FWY
Practice Address - Street 2:STE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-7018
Practice Address - Country:US
Practice Address - Phone:214-912-2614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68630101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty