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Organization
INNOVATIVE CENTERED COUNSELING INC.
Active
Organization
INNOVATIVE CENTERED COUNSELING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOSES CHISM JR. LPC (DIRECTOR)
(972) 298-2020
Entity
Organization
Contact information
Practice address
1102 SANTA FE TRL, STE 3, DUNCANVILLE, TX 75137-3062
(972) 298-2020
(972) 298-2020
Mailing address
1102 SANTA FE TRL, STE 3, DUNCANVILLE, TX 75137-3062
(972) 298-2020
(972) 298-2020
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
65923
TX
Other
Enumeration date
03/23/2012
Last updated
03/28/2013
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