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Organization

AVANTI COUNSELING & CONSULTING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEREMY L PIERCE MA, LPC-S, LMFT-S (CLINICAL DIRECTOR)
(682) 593-5693
Entity
Organization

Contact information

Practice address
1560 E SOUTHLAKE BLVD STE 100, SOUTHLAKE, TX 76092-6462
(682) 593-5693
Mailing address
4056 SUMMERHILL LN, FORT WORTH, TX 76244-4905
(832) 794-3209

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
106H00000X
Marriage & Family Therapist
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
08/08/2020
Last updated
08/08/2020
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