Organization
HIP HOP GLAMM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORRAINE KINGCANNON (CEO)
(214) 888-4401
Entity
Organization
Contact information
Practice address
3560 W CAMP WISDOM RD STE 200, DALLAS, TX 75237-2513
(214) 888-4401
(469) 574-5550
Mailing address
10440 N CENTRAL EXPY STE 800, DALLAS, TX 75231-2264
(214) 888-4401
(469) 574-5550
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
—
—
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
102X00000X
Poetry Therapist
—
—
251K00000X
Public Health or Welfare Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QS1000X
Student Health Clinic/Center
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
09/12/2024
Last updated
04/17/2025
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