1962791749 NPI number — TAMI HENDRIX

Table of content: (NPI 1962791749)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962791749 NPI number — TAMI HENDRIX

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TAMI HENDRIX
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ARLINGTON COUNSELING GROUP
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962791749
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5752 SKINNER WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND PRAIRIE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75052-0423
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-933-8106
Provider Business Mailing Address Fax Number:
817-375-1795

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5620 SW GREEN OAKS BLVD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76017-1160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-933-8106
Provider Business Practice Location Address Fax Number:
817-375-1795
Provider Enumeration Date:
04/01/2011

Additional Information

Authorized Official

Authorized Official Last Name:
HENDRIX
Authorized Official First Name:
TAMI
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER/ COUNSELOR
Authorized Official Telephone Number:
817-933-8106

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  65672 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP2500X , with the licence number: 65672 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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