GLC WELLNESS CENTER TEXAS LLC (NPI# 1700433653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700433653 |
| Entity Type | Organization |
| Organization Name | GLC WELLNESS CENTER TEXAS LLC |
| Practice Address |
1251 E Red Bird Ln Ste A Dallas TX 75241-2008 |
| Practice Telephone | 7025878106 |
| Practice Fax Number | 9726855108 |
| Mailing Telephone | 7025878106 |
| Mailing Fax Number | 9726855108 |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2020-01-15 |
| Authorized Official Name | DANTE YOUNG (CEO) |
| Authorized Official Telephone | 7025878106 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 405039501 | 05 |
| Street Address |
1251 E RED BIRD LN STE A |
| City | DALLAS |
| State | TX |
| Zip Code | 75241-2008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649888777 | Sonya Williams | Licensed Practical Nurse | 3481 Pinebrock Dr, Dallas, TX 75241 | 2020-07-15 |
| 1346700259 | Angel Vales | Counselor | 5520 Langdon Rd, Dallas, TX 75241 | 2019-03-25 |
| 1144708611 | Brandie L Mccray | Counselor | 155 Idlewheat Ln, Dallas, TX 75241 | 2018-08-06 |
| 1649792144 | Jessica Franco Skinner | Social Worker | 5520 Langdon Rd., Suite B, C/o Wilmer Hutchins Youth and Family Center, Dallas, TX 75241 | 2017-07-17 |
| 1659790756 | Michele S Gomez | Technician | 3984 Texas College Drive, Dallas, TX 75241 | 2014-04-16 |
| 1013223494 | Jennifer Peterson | Assisted Living Facility | 4160 Clark College Dr., Dallas, TX 75241 | 2010-08-24 |
| 1447561394 | Tricia Davis | Social Worker | 1568 Sax Leigh Dr, Dallas, TX 75241 | 2010-06-25 |
| 1871804989 | Sonya Williams | Case Management | 3481pinebrook Dr, Dallas, TX 75241 | 2010-06-24 |
| 1144468414 | Edwin Ng | Dentist | 1500 E Langdon Rd, Dallas, TX 75241 | 2009-01-26 |
| 1578709135 | Lynita Teresa Fisher | Registered Nurse | 1244 Serenade Lane, Dallas, TX 75241 | 2008-12-31 |
| Find all providers in zip 75241 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396313 | On Epiphany Lane, LLC | Counselor | 603 Munger Ave Ste 100, Dallas, TX 75202-1840 | 2020-11-02 |
| 1487253951 | Shanler Leigh Hoover | Counselor | 12800 Hillcrest Rd # A103, Dallas, TX 75230-1524 | 2020-10-25 |
| 1316546385 | Paola Guadalupe Garcia | Counselor | 8338 Midland Ln, Dallas, TX 75217-8850 | 2020-10-21 |
| 1447858378 | Theresa Lashonda Lucie Moody | Counselor | 3653 Briargrove Ln Apt 1036, Dallas, TX 75287-6155 | 2020-10-13 |
| 1609473693 | Donna Smith | Counselor | 3766 Seguin Dr, Dallas, TX 75220-6329 | 2020-10-03 |
| 1659978849 | Brian Williams | Counselor | 75 Log Cabin Dr Apt 821, Dallas, GA 30157-1689 | 2020-10-01 |
| 1285241349 | Nichole Gabrielle Brown | Counselor | 5045 Thunder Rd, Dallas, TX 75244-6546 | 2020-09-23 |
| 1366058588 | Vicki Smith-lockhart | Counselor | 4041 W Wheatland Rd Ste 106, Dallas, TX 75237-4060 | 2020-09-22 |
| 1881206928 | Angela Grace Leach | Counselor | 6511 Walnut Hill Ln, Dallas, TX 75230-5318 | 2020-08-19 |
| 1093324055 | Alita Rose Andrews | Counselor | 3905 Highgrove Dr, Dallas, TX 75220-3753 | 2020-07-27 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.