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Organization
PRACTICAL COUNSELING SERVICES
Active
Organization
PRACTICAL COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LESHAUNNE CHARISE COXUM LPC (CEO/THERAPIST)
(817) 829-4749
Entity
Organization
Contact information
Practice address
3212 COLLINSWORTH ST STE 22, SUITE 22, FORT WORTH, TX 76107-6507
(817) 829-4749
Mailing address
PO BOX 16071, FORT WORTH, TX 76162-0071
(817) 829-4749
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
63906
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
284676801
—
TX
01
—
284676802
MEDICAID CSHCN
—
Enumeration date
10/02/2012
Last updated
10/02/2012
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