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Organization

SOUTHLAKE THERAPY GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BAILEY PITTMAN MS, LPC (OWNER)
(817) 290-6908
Entity
Organization

Contact information

Practice address
1701 W NORTHWEST HWY, GRAPEVINE, TX 76051-8127
(817) 290-6908
Mailing address
2025 N HILL DR, IRVING, TX 75038-6217

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
03/31/2025
Last updated
03/31/2025
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