Individual
ISIS PEABODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1341 W MOCKINGBIRD LN, DALLAS, TX 75247-6913
(214) 456-7000
Mailing address
1341 W MOCKINGBIRD LN, DALLAS, TX 75247-6913
(214) 456-7000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
68724
TX
101YM0800X
Mental Health Counselor
68724
TX
101YP1600X
Pastoral Counselor
68724
TX
101YP2500X
Professional Counselor
68724
TX
101YS0200X
School Counselor
68724
TX
1041C0700X
Clinical Social Worker
Primary
68724
TX
1041S0200X
School Social Worker
68724
TX
106H00000X
Marriage & Family Therapist
68724
TX
Other
Enumeration date
04/14/2025
Last updated
07/09/2025
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