Organization
LIFETRACK COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL WICHMAN MS, LPC, LCDC (MEMBER MANAGER)
(972) 977-0203
Entity
Organization
Contact information
Practice address
904 GRANGER DR, ALLEN, TX 75013-1102
(972) 977-0203
Mailing address
904 GRANGER DR, ALLEN, TX 75013-1102
(972) 977-0203
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
70313
TX
Other
Enumeration date
08/22/2017
Last updated
06/12/2023
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