ON EPIPHANY LANE, LLC
Counselor (Mental Health)

Address: 603 Munger Ave Ste 100, Dallas, TX 75202-1840

ON EPIPHANY LANE, LLC (NPI# 1891396313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891396313
Entity Type Organization
Organization Name ON EPIPHANY LANE, LLC
Practice Address 603 Munger Ave Ste 100
Dallas
TX 75202-1840
Practice Telephone 2145600304
Mailing Address 603 Munger Ave # 100-239
Dallas
TX 75202-1839
Mailing Telephone 2145600304
Certification Date 2020-11-02
Enumeration Date 2020-11-02
Last Update Date 2020-11-02
Authorized Official Telephone 2145600304
Authorized Official Credential LPC-S
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
N 101YM0800X Counselor
Specialization: Mental Health
193200000X MULTI-SPECIALTY GROUP Behavioral Health & Social Service Providers
N 101YP2500X Counselor
Specialization: Professional
193200000X MULTI-SPECIALTY GROUP Behavioral Health & Social Service Providers
N 251K00000X Public Health or Welfare Agencies
N 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities

Other Provider Identifiers

Identifier State Issuer Type Code
1215272737 TX NPI Other

Other Provider/Organization Names

Other Name Type Code
Epiphany Lane Counseling Doing Business As Name

Office Location

Street Address 603 MUNGER AVE STE 100
City DALLAS
State TX
Zip Code 75202-1840

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205443371 Bridgewater Health Supplies LLC Durable Medical Equipment & Medical Supplies 603 Munger Ave Ste 1001011, Dallas, TX 75202-1839 2020-09-23

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1689299273 Wade Walters Pharmacist 1411 Mian Street, Dallas, TX 75202 2020-06-10
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1790275329 Chinenye Ann Amajor Nurse Practitioner - Family 1717 Mckinney Ave Ste 700, Dallas, TX 75202-1241 2018-05-18
1003309592 Courtney Cunningham Ellis Dentist 1777 N Record St Apt 2402, Dallas, TX 75202-1260 2018-06-11
1588153357 David Kohler Contractor 1445 Ross Ave, Dallas, TX 75202-2711 2018-05-07
1659974020 Ashley H Wainscott Pharmacist 1411 Main St, Dallas, TX 75202-4052 2020-11-18
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1396324356 Gelise Marie Porter Student in an Organized Health Care Education/Training Program 1200 Main St Apt 2505, Dallas, TX 75202-4318 2021-04-06
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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

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1093277071 Healthworks Med Group of Texas Darlington P A · At & T Health and Wellness Center Clinic/Center - Multi-Specialty 208 S Akard St Ste PC-50, Dallas, TX 75202-4206 2019-04-01
1932660636 365 Health, Pllc · Dallas 365 Health Clinic/Center - Multi-Specialty 6060 N Central Expy Ste 424, Dallas, TX 75206-5298 2019-03-26
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1104390533 Finding Home Healthcare, Inc. Clinic/Center - Multi-Specialty 6606 Lbj Fwy Ste 110, Dallas, TX 75240-6552 2019-01-18
1306311444 Open Arms Healthcare of Texas Inc. Clinic/Center - Multi-Specialty 10909 Webb Chapel Rd # 121, Dallas, TX 75229-3739 2018-10-04
1730669805 His Sacred Path Midwifery Clinic/Center - Multi-Specialty 350 N Saint Paul St Apt 2610, Dallas, TX 75201-4224 2018-08-17
1326543547 Allergy Pros Usa LLC Clinic/Center - Multi-Specialty 701 Commerce St Ste 410, Dallas, TX 75202-4578 2018-03-28
1942704283 Zoom Initiative Incorporated Clinic/Center - Multi-Specialty 12959 Jupiter Rd., Suite 140, Dallas, TX 75238 2018-03-21
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City DALLAS
Zip Code 75202

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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