Provider Demographics
NPI:1972183119
Name:WYSONG ENTERPRISES, PLLC
Entity type:Organization
Organization Name:WYSONG ENTERPRISES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WYSONG-WAREN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:214-906-5138
Mailing Address - Street 1:7424 AZALEA LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-3640
Mailing Address - Country:US
Mailing Address - Phone:214-906-5138
Mailing Address - Fax:
Practice Address - Street 1:4040 N CENTRAL EXPY STE 210
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-3868
Practice Address - Country:US
Practice Address - Phone:214-906-5138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty