Organization
THE SOURCE COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMERA SERGIE LPC-S (OWNER)
(214) 810-0872
Entity
Organization
Contact information
Practice address
1409 BOTHAM JEAN BLVD APT 416, DALLAS, TX 75215-6805
(214) 810-0872
Mailing address
1409 BOTHAM JEAN BLVD APT 416, DALLAS, TX 75215-6805
(214) 810-0872
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
09/16/2022
Last updated
09/16/2022
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