Provider Demographics
NPI:1588121214
Name:ANDERSON, NATALIE ALAYNE (LPC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ALAYNE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ALAYNE
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7912 NIMROD TRL
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-4137
Mailing Address - Country:US
Mailing Address - Phone:469-265-1204
Mailing Address - Fax:
Practice Address - Street 1:8140 WALNUT HILL LN STE 440
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4350
Practice Address - Country:US
Practice Address - Phone:972-813-9580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68926101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional