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Organization
FUNDAMENTAL FOUNDATIONS COUNSELING CENTER, PLLC
Active
Organization
FUNDAMENTAL FOUNDATIONS COUNSELING CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHIDRAH R COWGILL LPC-S (OWNER/CLINICAL DIRECTOR)
(214) 475-0345
Entity
Organization
Contact information
Practice address
2601 LITTLE ELM PKWY STE 302, LITTLE ELM, TX 75068-1919
(214) 475-0345
(214) 935-3302
Mailing address
2601 LITTLE ELM PKWY STE 302, LITTLE ELM, TX 75068-1919
(214) 475-0345
(214) 935-3302
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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