Organization
SOLACE COUNSELING ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN NOEL ODEA LPC (ADMINISTRATIVE DIRECTOR)
(214) 522-4640
Entity
Organization
Contact information
Practice address
1475 PRUDENTIAL DR, DALLAS, TX 75235-4109
(214) 522-4640
(214) 522-4650
Mailing address
1475 PRUDENTIAL DR, DALLAS, TX 75235-4109
(214) 522-4640
(214) 522-4650
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
14647
TX
101Y00000X
Counselor
15717
TX
103TC0700X
Clinical Psychologist
24933
TX
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
J4423
TX
251S00000X
Community/Behavioral Health Agency
2174-A
TX
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
3312
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150488801
—
TX
Enumeration date
08/09/2006
Last updated
11/22/2010
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