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Organization
VIVIFY COUNSELING AND COACHING PLLC
Active
Organization
VIVIFY COUNSELING AND COACHING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT BOATWRIGHT (COFOUNDER)
(972) 754-0788
Entity
Organization
Contact information
Practice address
3613 W PIONEER PKWY STE A, PANTEGO, TX 76013-4517
(972) 754-0788
Mailing address
4900 BRADLEY LN, ARLINGTON, TX 76017-3051
(972) 754-0788
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
02/08/2022
Last updated
03/26/2024
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