Provider Demographics
NPI:1992425250
Name:TABAKS, ALFRED ANTHONY (LPC)
Entity type:Individual
Prefix:
First Name:ALFRED
Middle Name:ANTHONY
Last Name:TABAKS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 LEIGHTON DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-3225
Mailing Address - Country:US
Mailing Address - Phone:817-247-9786
Mailing Address - Fax:
Practice Address - Street 1:3636 N MACARTHUR BLVD STE 160
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3601
Practice Address - Country:US
Practice Address - Phone:972-375-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82054101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health