Provider Demographics
NPI: | 1134925969 |
---|---|
Name: | UNIVERSITY PARK COUNSELING & TESTING CENTER, PLLC |
Entity type: | Organization |
Organization Name: | UNIVERSITY PARK COUNSELING & TESTING CENTER, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO/ PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TWILA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FARRAR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MED |
Authorized Official - Phone: | 972-825-6570 |
Mailing Address - Street 1: | PO BOX 687 |
Mailing Address - Street 2: | |
Mailing Address - City: | KEMP |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75143-0687 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 940-231-1942 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 5728 LYNDON B JOHNSON FWY STE 250 |
Practice Address - Street 2: | |
Practice Address - City: | DALLAS |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75240-6323 |
Practice Address - Country: | US |
Practice Address - Phone: | 972-825-6570 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-02-21 |
Last Update Date: | 2025-02-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 106E00000X | Behavioral Health & Social Service Providers | Assistant Behavior Analyst | Group - Multi-Specialty | |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
No | 106S00000X | Behavioral Health & Social Service Providers | Behavior Technician | Group - Multi-Specialty | |
No | 163WP0807X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health, Child & Adolescent | Group - Multi-Specialty |
No | 163WP0808X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health | Group - Multi-Specialty |
No | 163WP0809X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health, Adult | Group - Multi-Specialty |
No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |