# FUNDAMENTAL FOUNDATIONS COUNSELING CENTER, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417314089
- **Authorized official:** SHAHIDRAH COWGILL LPC-S, NCC (CEO/ CLINICAL DIRECTOR)
- **Authorized official phone:** (214) 475-0345

## Contact information

- **Practice address:** 2770 MAIN ST, STE. 280, FRISCO, TX 75033-4302
- **Practice address phone:** (214) 475-0345
- **Practice address fax:** (214) 935-3302
- **Mailing address:** 2770 MAIN ST, STE. 280, FRISCO, TX 75033-4302
- **Mailing address phone:** (214) 475-0345
- **Mailing address fax:** (214) 935-3302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 64254 | TX | Yes |

## Other

- **Enumeration date:** 01/27/2016
- **Last updated:** 01/27/2016