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Organization

ADDIJACKLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELE MENZIE LCSW-S (OWNER AND THERAPIST)
(940) 595-3778
Entity
Organization

Contact information

Practice address
145 CHAPARRAL EST, SHADY SHORES, TX 76208-5735
(940) 595-3778
Mailing address
145 CHAPARRAL EST, SHADY SHORES, TX 76208-5735
(940) 595-3778

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
12/08/2025
Last updated
12/08/2025
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